Provider Demographics
NPI:1942689831
Name:BRIGHTEN DENTAL CARE INC
Entity Type:Organization
Organization Name:BRIGHTEN DENTAL CARE INC
Other - Org Name:BRIGHTEN DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-922-4633
Mailing Address - Street 1:129 E DANIA BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:DANIA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33004-3032
Mailing Address - Country:US
Mailing Address - Phone:954-922-4633
Mailing Address - Fax:
Practice Address - Street 1:129 E DANIA BEACH BLVD
Practice Address - Street 2:
Practice Address - City:DANIA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33004-3032
Practice Address - Country:US
Practice Address - Phone:954-922-4633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-25
Last Update Date:2015-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN10515261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0777889-00Medicaid