Organization
BRILLIANT DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN BRIL DDS (OWNER)
(612) 845-0542
Entity
Organization
Contact information
Practice address
7727 FLYING CLOUD DR, EDEN PRAIRIE, MN 55344-3708
(952) 944-2052
Mailing address
7727 FLYING CLOUD DR, EDEN PRAIRIE, MN 55344-3708
(952) 944-2052
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D12438
MN BOARD OF DENTISTRY
MN
Enumeration date
05/18/2021
Last updated
05/19/2021
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