Provider Demographics
NPI:1699114777
Name:SMILE BRIGHT DENTAL CENTER PC
Entity type:Organization
Organization Name:SMILE BRIGHT DENTAL CENTER PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISABEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:NOY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:786-797-4695
Mailing Address - Street 1:18 W 140 BUTTERFIELD RD
Mailing Address - Street 2:1500 082
Mailing Address - City:OAK BROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-1500
Mailing Address - Country:US
Mailing Address - Phone:786-797-4695
Mailing Address - Fax:305-444-4213
Practice Address - Street 1:18 W 140 BUTTERFIELD RD
Practice Address - Street 2:1500 082
Practice Address - City:OAK BROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-1500
Practice Address - Country:US
Practice Address - Phone:786-797-4695
Practice Address - Fax:305-444-4213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN129391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty