| Brighter Way Dental Center | |
|
230 S 12th Ave Phoenix AZ 85007-3101 | |
| (602) 362-0744 | |
| Not Available |
| Full Name | Brighter Way Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 230 S 12th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Kris Volcheck (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6023535435 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brighter Way Dental Center 3140 W Buckeye Rd Phoenix AZ 85009-5637 Ph: (602) 353-5435 | Brighter Way Dental Center 230 S 12th Ave Phoenix AZ 85007-3101 Ph: (602) 362-0744 |
| NPI Number | 1487014965 |
|---|---|
| Provider Enumeration Date | 02/26/2016 |
| Last Update Date | 02/26/2016 |
| Medicare PECOS PAC ID | 7315343530 |
|---|---|
| Medicare Enrollment ID | O20210913002814 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487014965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| Provider Name | Kris A Volcheck |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1104937606 PECOS PAC ID: 1658783295 Enrollment ID: I20201223001632 |
| Provider Name | Michael David Rosen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1700499068 PECOS PAC ID: 9739509365 Enrollment ID: I20221205000525 |
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