| Bright Smiles, P.a. | |
|
4115 Wilkens Ave Ste 101 Baltimore MD 21229-4750 | |
| (410) 737-9666 | |
| (410) 737-9667 |
| Full Name | Bright Smiles, P.a. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4115 Wilkens Ave Ste 101, Baltimore, Maryland |
| Authorized Official Name and Position | Shankari Kumarachandran (PRESIDENT) |
| Authorized Official Contact | 4107379666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Smiles, P.a. 4115 Wilkens Ave Ste 101 Baltimore MD 21229-4750 Ph: (410) 737-9666 | Bright Smiles, P.a. 4115 Wilkens Ave Ste 101 Baltimore MD 21229-4750 Ph: (410) 737-9666 |
| NPI Number | 1205013554 |
|---|---|
| Provider Enumeration Date | 01/29/2008 |
| Last Update Date | 11/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205013554 | NPI | - | NPPES |
| 404887300 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 11814 (Maryland) | Primary |
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