Provider Demographics
NPI:1598948887
Name:WESLEY H. BRIDGES, D.D.S., P.A.
Entity Type:Organization
Organization Name:WESLEY H. BRIDGES, D.D.S., P.A.
Other - Org Name:BRIDGES & BRIDGES, D.D.S, P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:HUDSON
Authorized Official - Last Name:BRIDGES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:828-324-8838
Mailing Address - Street 1:504 MULBERRY ST SW
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5761
Mailing Address - Country:US
Mailing Address - Phone:828-758-4415
Mailing Address - Fax:828-754-4494
Practice Address - Street 1:504 MULBERRY ST SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5761
Practice Address - Country:US
Practice Address - Phone:828-758-4415
Practice Address - Fax:828-754-4494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2008-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7960261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental