Organization
BRIGHT SMILE FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEHAN ADAM (PRESIDENT)
(917) 547-4470
Entity
Organization
Contact information
Practice address
12601 WESTERN AVE, UNIT B, BLUE ISLAND, IL 60406-1749
(708) 293-1903
Mailing address
12601 WESTERN AVE, UNIT B, BLUE ISLAND, IL 60406-1749
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019027109
IL
Other
Enumeration date
12/03/2011
Last updated
12/03/2011
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