Provider Demographics
NPI:1982294419
Name:BRITE SMILES LLC
Entity Type:Organization
Organization Name:BRITE SMILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:YEFIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KANDOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-345-6500
Mailing Address - Street 1:204 N WEST ST STE 104
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-3507
Mailing Address - Country:US
Mailing Address - Phone:215-345-6500
Mailing Address - Fax:215-345-6501
Practice Address - Street 1:204 N WEST ST STE 104
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-3507
Practice Address - Country:US
Practice Address - Phone:215-365-6500
Practice Address - Fax:215-365-6501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty