| Brite Smiles Dental Care | |
|
8977 Hunters Way Apple Valley MN 55124 | |
| (952) 891-8484 | |
| (952) 891-1256 |
| Full Name | Brite Smiles Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 8977 Hunters Way, Apple Valley, Minnesota |
| Authorized Official Name and Position | Dennis C Simmons (DENTIST) |
| Authorized Official Contact | 9528918484 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brite Smiles Dental Care 8977 Hunters Way Apple Valley MN 55124 Ph: (952) 891-8484 | Brite Smiles Dental Care 8977 Hunters Way Apple Valley MN 55124 Ph: (952) 891-8484 |
| NPI Number | 1588774152 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8325365935 |
|---|---|
| Medicare Enrollment ID | O20150319001073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588774152 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D8270 (Minnesota) | Primary |
| Provider Name | Dennis Simmons |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1528232782 PECOS PAC ID: 9931424272 Enrollment ID: I20150518002109 |
| Provider Name | Lisa A Edstrom |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1922235027 PECOS PAC ID: 2860712767 Enrollment ID: I20150529002580 |
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