Provider Demographics
NPI:1356329759
Name:GEORGE I BRIDGES DDS INC
Entity Type:Organization
Organization Name:GEORGE I BRIDGES DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:I
Authorized Official - Last Name:BRIDGES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:580-581-9500
Mailing Address - Street 1:4006 NW CACHE RD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-3634
Mailing Address - Country:US
Mailing Address - Phone:580-581-9500
Mailing Address - Fax:580-581-0984
Practice Address - Street 1:4006 NW CACHE RD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-0984
Practice Address - Country:US
Practice Address - Phone:580-581-9500
Practice Address - Fax:580-581-0984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3215122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty