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NPI Code Detail

MEDICARE: BRIDGER ALLEN D.M.D.

MEDICARE: BRIDGER ALLEN D.M.D.
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
1122300000XDentist3689-13MS
21223P0221XPediatric DentistryPEDO-574-19MS

General Provider Information

NPI Number : 1770923815
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGER ALLEN D.M.D.
Provider Business Mailing Address
First Line : 8151 E INDIAN BEND RD
Second Line : STE. 111
City : SCOTTSDALE
State : AZ
Zip : 85250-4826
Country : US
Telephone Number : 480-607-9999
Fax Number :
Provider Business Practice Location Address
First Line : 2300 N HILLS ST
Second Line :
City : MERIDIAN
State : MS
Zip : 39305-2633
Country : US
Telephone Number : 601-484-3140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2013
Last Update Date : 08/23/2021

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Directions to “ BRIDGER ALLEN D.M.D.” Practice Location

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