Provider Demographics
NPI:1063052660
Name:BRIGHT SMILES OF GARLAND PLLC
Entity type:Organization
Organization Name:BRIGHT SMILES OF GARLAND PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHADEVI
Authorized Official - Middle Name:
Authorized Official - Last Name:GOTTIGERE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-595-0949
Mailing Address - Street 1:12547 HONEYFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0712
Mailing Address - Country:US
Mailing Address - Phone:313-595-0949
Mailing Address - Fax:
Practice Address - Street 1:2001 S GLENBROOK DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-1712
Practice Address - Country:US
Practice Address - Phone:313-595-0949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty