Organization
BRIGHT SMILES DENTAL PROGRAM
Active
Parent organization
WEST SIDE COMMUNITY HEALTH SERVICE
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST SIDE COMMUNITY HEALTH SERVICE
Authorized official
BLAKE DARSOW (CFO)
(651) 602-7537
Entity
Organization
Contact information
Practice address
153 CESAR CHAVEZ ST, SAINT PAUL, MN 55107-2226
(651) 602-7500
(651) 602-7580
Mailing address
153 CESAR CHAVEZ ST, SAINT PAUL, MN 55107-2226
(651) 602-7500
(651) 602-7580
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/29/2019
Last updated
03/29/2019
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