Organization
BRIGHT SMILE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SIRIN THANASASAVAT DMD (DENTIST)
(407) 412-7887
Entity
Organization
Contact information
Practice address
8010 SUNPORT DR STE 115, ORLANDO, FL 32809-7897
(407) 412-7887
(407) 641-8932
Mailing address
8010 SUNPORT DR STE 115, ORLANDO, FL 32809-7897
(407) 412-7887
(407) 641-8932
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN17989
FL
1223G0001X
General Practice Dentistry
DN17990
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076828600
—
FL
05
—
625034838
—
FL
Enumeration date
03/10/2015
Last updated
03/10/2015
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