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Organization

BRIGHTSIDE DENTAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRANDY LOPEZ (VICE PRESIDENT OF OPERATIONS)
(970) 596-8085
Entity
Organization

Contact information

Practice address
4731 S COCHISE DR STE 110, INDEPENDENCE, MO 64055-6943
(816) 704-0818
Mailing address
4731 S COCHISE DR STE 110, INDEPENDENCE, MO 64055-6943
(816) 704-0816

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
08/18/2021
Last updated
10/02/2025
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