Provider Demographics
NPI:1013187160
Name:SMILE BRIGHT DENTAL CORP.
Entity Type:Organization
Organization Name:SMILE BRIGHT DENTAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-887-3399
Mailing Address - Street 1:2021 MIDWEST ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523
Mailing Address - Country:US
Mailing Address - Phone:866-887-3399
Mailing Address - Fax:
Practice Address - Street 1:2021 MIDWEST RD
Practice Address - Street 2:SUITE 200
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1342
Practice Address - Country:US
Practice Address - Phone:866-887-3399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty