| NPI | 1972058428 |
|---|---|
| Doing Business As | BRIDGEPORT FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | DARILYN HENRY General Manager 253-564-9633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA de00005432) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2016-08-24 |