Provider Demographics
NPI:1588454011
Name:BRITEDENT IYA PC
Entity type:Organization
Organization Name:BRITEDENT IYA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-850-3325
Mailing Address - Street 1:485 NEWTON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30607
Mailing Address - Country:US
Mailing Address - Phone:706-850-3325
Mailing Address - Fax:706-850-3327
Practice Address - Street 1:485 NEWTON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30607
Practice Address - Country:US
Practice Address - Phone:706-850-3325
Practice Address - Fax:706-850-3327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty