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NPI Code Detail

MEDICARE: BRIDENT DENTAL ASSOCIATES PC

MEDICARE: BRIDENT DENTAL ASSOCIATES PC
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
1122300000XDentist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922571017
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIDENT DENTAL ASSOCIATES PC
Provider Business Mailing Address
First Line : 530 S MAIN ST STE 600
Second Line :
City : ORANGE
State : CA
Zip : 92868-4544
Country : US
Telephone Number : 714-480-3000
Fax Number : 714-571-6445
Provider Business Practice Location Address
First Line : 5819 GULF FWY STE 600
Second Line :
City : HOUSTON
State : TX
Zip : 77023-5353
Country : US
Telephone Number : 713-923-5499
Fax Number : 713-923-5752
Authorized Official
Title or Position : ENROLLMENT COORDINATOR
Name : MARIBEL ZAMORA
Credential :
Telephone Number : 714-571-3104
Provider Enumeration Date : 01/10/2019
Last Update Date : 01/10/2019

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Directions to “BRIDENT DENTAL ASSOCIATES PC ” Practice Location

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