| Brightnow Dental | |
|
4258 Belden Village Mall Space Fc-17 Canton OH 44718-2504 | |
| (330) 492-4250 | |
| (330) 492-4255 |
| Full Name | Brightnow Dental |
|---|---|
| Speciality | Dentist |
| Location | 4258 Belden Village Mall, Canton, Ohio |
| Authorized Official Name and Position | Diane L Ulichney (CREDENTIALING MANAGER) |
| Authorized Official Contact | 4403459068 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brightnow Dental 6315 Pearl Rd Ste 201 Parma Heights OH 44130-3074 Ph: (330) 345-9068 | Brightnow Dental 4258 Belden Village Mall Space Fc-17 Canton OH 44718-2504 Ph: (330) 492-4250 |
| NPI Number | 1538344569 |
|---|---|
| Provider Enumeration Date | 01/09/2008 |
| Last Update Date | 05/13/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538344569 | NPI | - | NPPES |
| 2618724 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 19758 (Ohio) | Primary |
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