Provider Demographics
NPI:1063847564
Name:JOHN N BRIDGER DDS INCORPORATED
Entity Type:Organization
Organization Name:JOHN N BRIDGER DDS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-266-2244
Mailing Address - Street 1:3400 S GESSNER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-7247
Mailing Address - Country:US
Mailing Address - Phone:713-266-2244
Mailing Address - Fax:
Practice Address - Street 1:3400 S GESSNER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-7247
Practice Address - Country:US
Practice Address - Phone:713-266-2244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1013781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty