| Brilliant Smiles Pediatric Dentistry, Llc | |
|
237 Halsey St Newark NJ 07102 | |
| (862) 955-2285 | |
| (862) 367-8219 |
| Full Name | Brilliant Smiles Pediatric Dentistry, Llc |
|---|---|
| Speciality | Dentist |
| Location | 237 Halsey St, Newark, New Jersey |
| Authorized Official Name and Position | Suffiyah Webb (OWNER - PEDIATRIC DENTIST) |
| Authorized Official Contact | 8629552285 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brilliant Smiles Pediatric Dentistry, Llc 243 Halsey St Newark NJ 07102-3746 Ph: (862) 955-2285 | Brilliant Smiles Pediatric Dentistry, Llc 237 Halsey St Newark NJ 07102 Ph: (862) 955-2285 |
| NPI Number | 1235862889 |
|---|---|
| Provider Enumeration Date | 07/01/2022 |
| Last Update Date | 07/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235862889 | NPI | - | NPPES |
| 0254576 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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