Provider Demographics
NPI:1508641937
Name:MAYER SMILE BE BRIGHT
Entity Type:Organization
Organization Name:MAYER SMILE BE BRIGHT
Other - Org Name:MAYER SMILE BE BRIGHT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-277-3592
Mailing Address - Street 1:814 VILLA RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3663
Mailing Address - Country:US
Mailing Address - Phone:571-366-3992
Mailing Address - Fax:571-366-3994
Practice Address - Street 1:6500 WILLIAMSBURG BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22213-1329
Practice Address - Country:US
Practice Address - Phone:571-366-3992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty