Provider Demographics
NPI:1598823031
Name:MODERN DENTAL PROFESSIONALS - SANDHU, INC.
Entity Type:Organization
Organization Name:MODERN DENTAL PROFESSIONALS - SANDHU, INC.
Other - Org Name:BRIGHT NOW DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAVDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-578-6358
Mailing Address - Street 1:8415 DATAPOINT DR
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3298
Mailing Address - Country:US
Mailing Address - Phone:714-578-6358
Mailing Address - Fax:
Practice Address - Street 1:6040 WILMINGTON PIKE
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-7006
Practice Address - Country:US
Practice Address - Phone:937-848-3024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.023513122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty