Provider Demographics
NPI:1295224004
Name:WOODFORD, BRIDGET (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:
Last Name:WOODFORD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38671 AMBERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-4783
Mailing Address - Country:US
Mailing Address - Phone:216-849-7517
Mailing Address - Fax:
Practice Address - Street 1:16716 CHILLICOTHE RD STE 700
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-6504
Practice Address - Country:US
Practice Address - Phone:440-708-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0253851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice