Provider Demographics
NPI:1467949123
Name:EBRIGHT & SMART FAMILY DENTISTRY
Entity Type:Organization
Organization Name:EBRIGHT & SMART FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:SMART
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-434-8800
Mailing Address - Street 1:77 GILCREAST RD STE 1004
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3518
Mailing Address - Country:US
Mailing Address - Phone:603-434-8800
Mailing Address - Fax:
Practice Address - Street 1:77 GILCREAST RD STE 1004
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3518
Practice Address - Country:US
Practice Address - Phone:603-434-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04063261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental