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Organization
BRILLIANT SMILES PEDIATRIC DENTISTRY, LLC
Active
Organization
BRILLIANT SMILES PEDIATRIC DENTISTRY, LLC
Active
Other names
Brilliant Smiles Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUFFIYAH WEBB DDS (OWNER - PEDIATRIC DENTIST)
(862) 955-2285
Entity
Organization
Contact information
Practice address
237 HALSEY ST, NEWARK, NJ 07102
(862) 955-2285
(862) 367-8219
Mailing address
243 HALSEY ST, NEWARK, NJ 07102-3746
(862) 955-2285
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0254576
—
NJ
Enumeration date
07/01/2022
Last updated
07/01/2022
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