NPI | 1568113082 |
---|---|
Former Legal Business Name | BRIGHT STARR PEDIATRIC DENTISTRY, LLC |
Entity Type | Organization |
Authorized Contact | EBONEE MONIQUE THROWER Owner 240-764-5753 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2022-01-17 |
Last Update Date | 2022-01-17 |