Brilliant Smile Dental, P.c.

NPI #1215209861 in Portland, Oregon

Provider Information

NPI Number: 1215209861
Entity Type: Organization
Organization Name: Brilliant Smile Dental, P.c.
Primary Specialty: Dentist
Enumeration Date: Jan 28, 2012
Last Updated: Jan 31, 2014

Practice Location

Address: 12720 SE STARK ST
City: Portland
State: Oregon
ZIP Code: 97233-1539
Phone: (503) 252-6133

Authorized Official

Name: DR. NICOLE NGA LUONG, DDS
Title: PRESIDENT
Phone: (503) 708-8059

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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