Provider Demographics
NPI:1952709073
Name:BRIGHT SMILES DENTAL CENTER, P.C.
Entity Type:Organization
Organization Name:BRIGHT SMILES DENTAL CENTER, P.C.
Other - Org Name:BRIGHT SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SANGITA
Authorized Official - Middle Name:
Authorized Official - Last Name:VENKATESH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:678-922-8282
Mailing Address - Street 1:907 BUFORD RD
Mailing Address - Street 2:#100
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-2710
Mailing Address - Country:US
Mailing Address - Phone:678-922-8282
Mailing Address - Fax:678-310-1332
Practice Address - Street 1:907 BUFORD RD
Practice Address - Street 2:#100
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-2710
Practice Address - Country:US
Practice Address - Phone:678-922-8282
Practice Address - Fax:678-310-1332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-06
Last Update Date:2014-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty