| Brilliance Dental | |
|
3105 Church Ave Suite 2 Brooklyn NY 11226-4211 | |
| (718) 287-1300 | |
| (718) 287-5530 |
| Full Name | Brilliance Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3105 Church Ave, Brooklyn, New York |
| Authorized Official Name and Position | Paul J Gomes (ADMINISTRATOR) |
| Authorized Official Contact | 9179515105 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brilliance Dental 3105 Church Ave Suite 2 Brooklyn NY 11226-4211 Ph: (718) 287-1300 | Brilliance Dental 3105 Church Ave Suite 2 Brooklyn NY 11226-4211 Ph: (718) 287-1300 |
| NPI Number | 1639370380 |
|---|---|
| Provider Enumeration Date | 05/30/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639370380 | NPI | - | NPPES |
| 01739179 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 046446 (New York) | Primary |
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