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NPI Code Detail

MEDICARE: HOLLYWOOD BRIGHT SMILE SPA PLLC

MEDICARE: HOLLYWOOD BRIGHT SMILE SPA PLLC
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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1376154161
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOLLYWOOD BRIGHT SMILE SPA PLLC
Provider Business Mailing Address
First Line : 2699 STIRLING RD STE C203
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33312-6580
Country : US
Telephone Number : 954-374-9993
Fax Number :
Provider Business Practice Location Address
First Line : 2699 STIRLING RD STE C203
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33312-6580
Country : US
Telephone Number : 954-374-9993
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : DR. SHARY ASK
Credential : DMD FAGD
Telephone Number : 954-374-9993
Provider Enumeration Date : 08/14/2020
Last Update Date : 08/17/2020

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Directions to “HOLLYWOOD BRIGHT SMILE SPA PLLC ” Practice Location

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