Provider Demographics
NPI:1154634905
Name:SMILE BRIGHT DENTAL 54 PLC
Entity Type:Organization
Organization Name:SMILE BRIGHT DENTAL 54 PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:813-885-3900
Mailing Address - Street 1:7280 STATE ROAD 54
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-6125
Mailing Address - Country:US
Mailing Address - Phone:727-807-3355
Mailing Address - Fax:727-807-3344
Practice Address - Street 1:7280 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-6125
Practice Address - Country:US
Practice Address - Phone:727-807-3355
Practice Address - Fax:727-807-3344
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMILE BRIGHT DENTAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty