MEDICARE: BRIGHT CHOICE DENTAL GROUP LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1124745302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT CHOICE DENTAL GROUP LP

Provider Business Mailing Address
First Line	:	229 DEL ROCCO CT
Second Line	:
City	:	RARITAN
State	:	NJ
Zip	:	08869-2307
Country	:	US
Telephone Number	:	848-219-9197
Fax Number	:

Provider Business Practice Location Address
First Line	:	6784 MARKET ST
Second Line	:
City	:	UPPER DARBY
State	:	PA
Zip	:	19082-2431
Country	:	US
Telephone Number	:	848-219-9197
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALAMDEEP BRAR
Credential	:
Telephone Number	:	848-219-9197

Provider Enumeration Date	:	10/27/2022
Last Update Date	:	10/27/2022

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Directions to “BRIGHT CHOICE DENTAL GROUP LP ” Practice Location

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