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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