Provider Demographics
NPI:1275655383
Name:BRIGHT, ROLEEN THEOLA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROLEEN
Middle Name:THEOLA
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 CROWNE RESERVE DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244
Mailing Address - Country:US
Mailing Address - Phone:205-215-6145
Mailing Address - Fax:973-215-6144
Practice Address - Street 1:514 CROWNE RESERVE DR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-7040
Practice Address - Country:US
Practice Address - Phone:205-215-6145
Practice Address - Fax:973-215-6144
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL52601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice