Provider Demographics
NPI:1134510472
Name:CORNING BRIGHT DENTAL PLLC
Entity Type:Organization
Organization Name:CORNING BRIGHT DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:FANRUI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-458-6799
Mailing Address - Street 1:157 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-2811
Mailing Address - Country:US
Mailing Address - Phone:607-936-3131
Mailing Address - Fax:607-936-2068
Practice Address - Street 1:157 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2811
Practice Address - Country:US
Practice Address - Phone:607-936-3131
Practice Address - Fax:607-936-2068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0567631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty