Provider Demographics
NPI:1275675357
Name:BRIGHT, JEFFREY A (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:BRIGHT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N BROAD ST STE 7
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1032
Mailing Address - Country:US
Mailing Address - Phone:302-376-7882
Mailing Address - Fax:302-376-0405
Practice Address - Street 1:600 N BROAD ST STE 7
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1032
Practice Address - Country:US
Practice Address - Phone:302-376-7882
Practice Address - Fax:302-376-0405
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG100009921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000897208Medicaid