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NPI Code Detail

MEDICARE: DR. SUSAN HORLDT BRIDGES DDS

MEDICARE: DR. SUSAN HORLDT BRIDGES DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry7990NC

General Provider Information

NPI Number : 1033132667
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN HORLDT BRIDGES DDS
Provider Business Mailing Address
First Line : 441 16TH AVE NW
Second Line :
City : HICKORY
State : NC
Zip : 28601-2463
Country : US
Telephone Number : 828-403-8345
Fax Number :
Provider Business Practice Location Address
First Line : 322 1ST AVE SW
Second Line :
City : TAYLORSVILLE
State : NC
Zip : 28681-2402
Country : US
Telephone Number : 828-632-9704
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 07/08/2007

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