Provider Demographics
NPI:1083050389
Name:ORANGE COUNTY
Entity Type:Organization
Organization Name:ORANGE COUNTY
Other - Org Name:ORANGE COUNTY DENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRIDGER
Authorized Official - Suffix:
Authorized Official - Credentials:MPH,PHD
Authorized Official - Phone:919-245-2411
Mailing Address - Street 1:300 W TRYON ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-2438
Mailing Address - Country:US
Mailing Address - Phone:919-245-2435
Mailing Address - Fax:
Practice Address - Street 1:300 W TRYON ST
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2438
Practice Address - Country:US
Practice Address - Phone:919-245-2435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORANGE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC021KKOtherBCBSNC
NC7900OtherCIGNA DENTAL PPO
NC3404475Medicaid
NC=========OtherDELTA DENTAL OF NORTH CAROLINA