Organization
BRIGHT SMILES DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRASANNA KUMARI V MUDDANA (CO OWNER/OPERATIONS MANAGER)
(262) 563-9100
Entity
Organization
Contact information
Practice address
13500 W CAPITOL DR STE 103, BROOKFIELD, WI 53005-2444
(262) 563-9100
(262) 563-9101
Mailing address
13500 W CAPITOL DR STE 202, BROOKFIELD, WI 53005-2444
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/06/2021
Last updated
11/09/2021
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