Provider Demographics
NPI:1760954408
Name:BRIGHT SMILES DENTAL STUDIO,PA DBA
Entity Type:Organization
Organization Name:BRIGHT SMILES DENTAL STUDIO,PA DBA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WISDOM
Authorized Official - Middle Name:D
Authorized Official - Last Name:AKPAKA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:678-650-2198
Mailing Address - Street 1:730 GOODLETTE RD N STE 206
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5618
Mailing Address - Country:US
Mailing Address - Phone:239-262-4596
Mailing Address - Fax:239-649-6702
Practice Address - Street 1:730 GOODLETTE RD N STE 206
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5618
Practice Address - Country:US
Practice Address - Phone:239-262-4596
Practice Address - Fax:239-649-6702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty