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General NPI Number Information
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NPI Number | 1356360465
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Entity Type | Organization
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Legal Business Name | BRIDGEWATER DENTAL ASSOCIATES, PC
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 720 US HIGHWAY 202/206
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-1746
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Country | US
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Telephone | 908-707-1133
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Fax |
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Provider Business Mailing Address
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Address Line | 720 US HIGHWAY 202/206
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-1746
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Country | US
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Telephone | 908-707-1133
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID M. WEEDON
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Credential | DDS
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Telephone | 908-707-1133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 22DI01796000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI01640300
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License Number State | NJ
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