Organization
BRIGHT DENTAL AT BRIDGEPORT, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANGANAYAKI CHIRUMAMILLA (PRESIDENT)
(214) 336-9767
Entity
Organization
Contact information
Practice address
4575 MAIN ST, BRIDGEPORT, CT 06606-1818
(203) 371-6700
Mailing address
4575 MAIN ST, BRIDGEPORT, CT 06606-1818
(203) 371-6700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010397
CT
Other
Enumeration date
03/01/2012
Last updated
03/01/2012
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