Organization
DENTAL PROVIDER RESOURCES 3
Active
Other names
Radiant Smiles Mid Cities
Organization subpart
No
Provider details
NPI number
Authorized official
JARED BRUGGEMAN DDS (OWNER/DOCTOR)
(817) 328-6150
Entity
Organization
Contact information
Practice address
458 MID CITIES BLVD, HURST, TX 76054
(817) 571-2100
Mailing address
1000 TEXAN TRAIL STE 229, GRAPEVINE, TX 76051
(817) 328-6150
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/20/2012
Last updated
06/20/2012
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