Provider Demographics
NPI:1649710674
Name:BRIGHT WHITE DENTAL PLLC
Entity type:Organization
Organization Name:BRIGHT WHITE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RISHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCHANT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-460-8001
Mailing Address - Street 1:1101 PEACOCK BLVD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2944
Mailing Address - Country:US
Mailing Address - Phone:214-460-8001
Mailing Address - Fax:
Practice Address - Street 1:1101 PEACOCK BLVD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2944
Practice Address - Country:US
Practice Address - Phone:214-460-8001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization