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General NPI Number Information
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NPI Number | 1649982323
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Entity Type | Organization
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Legal Business Name | BRIDGEPOINTE FAMILY DENTAL LLC
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 230 BRIDGE ST
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City | METUCHEN
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State | NJ
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Zip | 08840-2291
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Country | US
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Telephone | 630-923-2666
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Fax |
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Provider Business Mailing Address
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Address Line | 799 S 3RD ST APT 2554
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City | HARRISON
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State | NJ
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Zip | 07029-2191
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SUNG HOON CHO
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Credential | DMD
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Telephone | 630-923-2666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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