Provider Demographics
NPI:1942741012
Name:BRIGHT DENTAL CARE PC
Entity Type:Organization
Organization Name:BRIGHT DENTAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GENG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:312-320-1908
Mailing Address - Street 1:112 MEETINGHOUSE POND
Mailing Address - Street 2:
Mailing Address - City:CHESTERBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19087-5514
Mailing Address - Country:US
Mailing Address - Phone:312-320-1908
Mailing Address - Fax:
Practice Address - Street 1:917 MACDADE BLVD
Practice Address - Street 2:
Practice Address - City:COLLINGDALE
Practice Address - State:PA
Practice Address - Zip Code:19023-3719
Practice Address - Country:US
Practice Address - Phone:312-320-1908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040208261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental