| NPI | 1881288058 |
|---|---|
| Doing Business As | BRIDGEPORT FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | SAMANTHA JETTE President 304-282-1640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-02-27 |
| Last Update Date | 2021-02-27 |