Provider Demographics
NPI:1710366166
Name:BRIGHT, CASSANDRA (RDH)
Entity Type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5925 LEHMAN DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916
Mailing Address - Country:US
Mailing Address - Phone:719-425-8964
Mailing Address - Fax:
Practice Address - Street 1:5925 LEHMAN DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80916
Practice Address - Country:US
Practice Address - Phone:719-425-8964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH002023493124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist