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Organization

SONRISAS BRIGHT DENTAL 1, LP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDWIN CHICCHON DDS (OWNER/DENTIST)
(510) 713-8986
Entity
Organization

Contact information

Practice address
959 WOODSIDE RD, REDWOOD CITY, CA 94061-3644
(650) 361-1801
(650) 361-1809
Mailing address
959 WOODSIDE RD, REDWOOD CITY, CA 94061-3644
(650) 361-1801
(650) 361-1809

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1609060649
NEA
CA
Enumeration date
08/23/2021
Last updated
08/23/2021
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