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NPI Code Detail

MEDICARE: BRIGHTEN DENTAL CARE INC

MEDICARE: BRIGHTEN DENTAL CARE INC
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/CenterDN10515FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942689831
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIGHTEN DENTAL CARE INC
Provider Business Mailing Address
First Line : 129 E DANIA BEACH BLVD
Second Line :
City : DANIA BEACH
State : FL
Zip : 33004-3032
Country : US
Telephone Number : 954-922-4633
Fax Number :
Provider Business Practice Location Address
First Line : 129 E DANIA BEACH BLVD
Second Line :
City : DANIA BEACH
State : FL
Zip : 33004-3032
Country : US
Telephone Number : 954-922-4633
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. CHANDER GUPTA
Credential : DDS
Telephone Number : 954-922-4633
Provider Enumeration Date : 05/25/2015
Last Update Date : 05/25/2015

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Directions to “BRIGHTEN DENTAL CARE INC ” Practice Location

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