Provider Demographics
NPI:1124745302
Name:BRIGHT CHOICE DENTAL GROUP LP
Entity type:Organization
Organization Name:BRIGHT CHOICE DENTAL GROUP LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAMDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-219-9197
Mailing Address - Street 1:229 DEL ROCCO CT
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-2307
Mailing Address - Country:US
Mailing Address - Phone:848-219-9197
Mailing Address - Fax:
Practice Address - Street 1:6784 MARKET ST
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-2431
Practice Address - Country:US
Practice Address - Phone:848-219-9197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental