| Trace Bridges Family Dentistry Pllc | |
|
2928 Nw Cache Rd Lawton OK 73505-3827 | |
| (580) 355-8300 | |
| (580) 355-8798 |
| Full Name | Trace Bridges Family Dentistry Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2928 Nw Cache Rd, Lawton, Oklahoma |
| Authorized Official Name and Position | George I. Trace Bridges (OWNER) |
| Authorized Official Contact | 5805367507 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trace Bridges Family Dentistry Pllc 2928 Nw Cache Rd Lawton OK 73505-3827 Ph: (580) 355-8300 | Trace Bridges Family Dentistry Pllc 2928 Nw Cache Rd Lawton OK 73505-3827 Ph: (580) 355-8300 |
| NPI Number | 1184714156 |
|---|---|
| Provider Enumeration Date | 10/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184714156 | NPI | - | NPPES |
| 860044 | Other | OK | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5215 (Oklahoma) | Primary |
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