Provider Demographics
NPI:1689753816
Name:LANG, BRIDGET (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:
Last Name:LANG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 MAIN AVENUE
Mailing Address - Street 2:SUITE A
Mailing Address - City:STIRLING
Mailing Address - State:NJ
Mailing Address - Zip Code:07980-1466
Mailing Address - Country:US
Mailing Address - Phone:973-376-2900
Mailing Address - Fax:973-376-4544
Practice Address - Street 1:285 MAIN AVENUE
Practice Address - Street 2:SUITE A
Practice Address - City:STIRLING
Practice Address - State:NJ
Practice Address - Zip Code:07980-1466
Practice Address - Country:US
Practice Address - Phone:973-376-2900
Practice Address - Fax:973-376-4544
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI015458001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice