Provider Demographics
NPI:1033784558
Name:HEALTHY & BRIGHT COSMETIC AND FAMILY DENTISTRY
Entity Type:Organization
Organization Name:HEALTHY & BRIGHT COSMETIC AND FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FOTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEFTA-HOSKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-353-7135
Mailing Address - Street 1:705 EXMOOR AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2703
Mailing Address - Country:US
Mailing Address - Phone:859-353-7135
Mailing Address - Fax:
Practice Address - Street 1:9509 US HIGHWAY 42 STE 102
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-9291
Practice Address - Country:US
Practice Address - Phone:502-228-3578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty