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General NPI Number Information
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NPI Number | 1598099947
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Entity Type | Organization
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Legal Business Name | BRIDGE DENTAL LLC
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Dates
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Enumeration Date | 10/01/2009
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Last Update Date | 10/01/2009
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Provider Practice Location Address
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Address Line | 53 WINDERMERE BLVD
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City | CHARLESTON
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State | SC
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Zip | 29407-7411
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Country | US
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Telephone | 843-225-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 53 WINDERMERE BLVD
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City | CHARLESTON
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State | SC
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Zip | 29407-7411
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Country | US
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Telephone | 843-225-0111
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANCIS WATES ADAMS JR.
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Credential | DMD
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Telephone | 843-343-9679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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