| Bright Smile Family Dentistry Pllc | |
|
3225 Teakwood Lane Edmond OK 73013 | |
| (405) 844-8887 | |
| (405) 844-9625 |
| Full Name | Bright Smile Family Dentistry Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3225 Teakwood Lane, Edmond, Oklahoma |
| Authorized Official Name and Position | Eli T. Jarjoura (OWNER) |
| Authorized Official Contact | 4052291234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Smile Family Dentistry Pllc P.o. Box 8110 Edmond OK 73083 Ph: (405) 844-8887 | Bright Smile Family Dentistry Pllc 3225 Teakwood Lane Edmond OK 73013 Ph: (405) 844-8887 |
| NPI Number | 1841473709 |
|---|---|
| Provider Enumeration Date | 12/13/2007 |
| Last Update Date | 07/24/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841473709 | NPI | - | NPPES |
| 200054280A | Medicaid | OK | |
| 200054290A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | (Oklahoma) | Primary |
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