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Organization
W&J DENTAL LLC
Active
Organization
W&J DENTAL LLC
Active
Other names
GLOWING SMILE DENTAL STUDIO
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOOD BAZERBASHI DDS (MANAGER)
(832) 661-8720
Entity
Organization
Contact information
Practice address
10231 E COLONIAL DR, ORLANDO, FL 32817-4353
(407) 985-2885
(407) 985-2887
Mailing address
10231 E COLONIAL DR, ORLANDO, FL 32817-4353
(407) 985-2885
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093317703
—
FL
05
—
1518048065
—
FL
Enumeration date
11/11/2021
Last updated
11/15/2021
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