Provider Demographics
NPI:1801267869
Name:B-BRIGHT DENTAL PLLC
Entity type:Organization
Organization Name:B-BRIGHT DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST SOLO MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-606-5820
Mailing Address - Street 1:17440 FM 529 RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-1167
Mailing Address - Country:US
Mailing Address - Phone:832-427-1901
Mailing Address - Fax:832-427-1997
Practice Address - Street 1:17440 FM 529 RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-1167
Practice Address - Country:US
Practice Address - Phone:832-427-1901
Practice Address - Fax:832-427-1997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty