| Bright Smile Family Dental | |
|
12601 Western Ave Unit B Blue Island IL 60406-1749 | |
| (708) 293-1903 | |
| Not Available |
| Full Name | Bright Smile Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 12601 Western Ave, Blue Island, Illinois |
| Authorized Official Name and Position | Gehan Adam (DDS) |
| Authorized Official Contact | 7082931903 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Smile Family Dental 12601 Western Ave Unit B Blue Island IL 60406-1749 Ph: () - | Bright Smile Family Dental 12601 Western Ave Unit B Blue Island IL 60406-1749 Ph: (708) 293-1903 |
| NPI Number | 1376083006 |
|---|---|
| Provider Enumeration Date | 02/28/2017 |
| Last Update Date | 02/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376083006 | NPI | - | NPPES |
| 1972566305 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019027109 (Illinois) | Primary |
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