| Bridgeport Family Dentistry | |
|
4620 Bridgeport Way W Ste B University Place WA 98466-4237 | |
| (253) 564-9633 | |
| Not Available |
| Full Name | Bridgeport Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 4620 Bridgeport Way W Ste B, University Place, Washington |
| Authorized Official Name and Position | Darilyn Henry (GENERAL MANAGER) |
| Authorized Official Contact | 2535649633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridgeport Family Dentistry 4620 Bridgeport Way W Ste B University Place WA 98466-4237 Ph: (253) 564-9633 | Bridgeport Family Dentistry 4620 Bridgeport Way W Ste B University Place WA 98466-4237 Ph: (253) 564-9633 |
| NPI Number | 1972058428 |
|---|---|
| Provider Enumeration Date | 08/24/2016 |
| Last Update Date | 08/24/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972058428 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE00005432 (Washington) | Primary |
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