Provider Demographics
NPI:1417408345
Name:DEAN, BRIDGET (NMD)
Entity Type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7517 S MCCLINTOCK DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-5011
Mailing Address - Country:US
Mailing Address - Phone:480-755-0060
Mailing Address - Fax:480-756-5707
Practice Address - Street 1:7517 S MCCLINTOCK DR
Practice Address - Street 2:SUITE 104
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-5011
Practice Address - Country:US
Practice Address - Phone:480-755-0060
Practice Address - Fax:480-756-5707
Is Sole Proprietor?:No
Enumeration Date:2016-10-15
Last Update Date:2016-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16-1582175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath