Provider Demographics
NPI:1568162279
Name:BRIGHT SMILE DENTAL ART LLC
Entity Type:Organization
Organization Name:BRIGHT SMILE DENTAL ART LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:
Authorized Official - Last Name:KASWALA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-429-6911
Mailing Address - Street 1:6722 ARBORDEAU LN
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-8794
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:41 W BROAD ST STE 1
Practice Address - Street 2:
Practice Address - City:TAMAQUA
Practice Address - State:PA
Practice Address - Zip Code:18252-1950
Practice Address - Country:US
Practice Address - Phone:570-668-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty