| Bright Smiles Orthodontics And Pediatric Dentistry | |
|
907 Pavilion Ct Mcdonough GA 30253-6665 | |
| (678) 583-8536 | |
| (678) 583-8657 |
| Full Name | Bright Smiles Orthodontics And Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 907 Pavilion Ct, Mcdonough, Georgia |
| Authorized Official Name and Position | Shunda L Thompson (OWNER) |
| Authorized Official Contact | 6785838536 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Smiles Orthodontics And Pediatric Dentistry 907 Pavilion Ct Mcdonough GA 30253-6665 Ph: (678) 583-8536 | Bright Smiles Orthodontics And Pediatric Dentistry 907 Pavilion Ct Mcdonough GA 30253-6665 Ph: (678) 583-8536 |
| NPI Number | 1003088873 |
|---|---|
| Provider Enumeration Date | 04/01/2008 |
| Last Update Date | 04/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003088873 | NPI | - | NPPES |
| 1235292897 | Medicaid | GA | |
| 9181762 | Other | GA | GA PROVIDER NUMBER |
| 1585058 | Other | GA | UNITED CONCORDIA |
| 9199332 | Other | GA | GA PROVIDER ID |
| 100486 | Other | GA | GA PROVIDER ID |
| 101869 | Other | GA | GA PROVIDER ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DN012649 (Georgia) | Primary |
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