Provider Demographics
NPI:1770297699
Name:DR SO BRIGHT DENTAL LLC
Entity type:Organization
Organization Name:DR SO BRIGHT DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:301-449-3350
Mailing Address - Street 1:7700 OLD BRANCH AVE STE E102
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-1628
Mailing Address - Country:US
Mailing Address - Phone:301-449-3350
Mailing Address - Fax:240-348-7837
Practice Address - Street 1:7700 OLD BRANCH AVE STE E102
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1628
Practice Address - Country:US
Practice Address - Phone:301-449-3350
Practice Address - Fax:240-348-7837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty