Provider Demographics
NPI:1902381643
Name:BRIDGES, CHRISTINA MARIE (RDH, QOM)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:RDH, QOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 ANNIES LN
Mailing Address - Street 2:
Mailing Address - City:BESSEMER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28016-8732
Mailing Address - Country:US
Mailing Address - Phone:704-913-3653
Mailing Address - Fax:
Practice Address - Street 1:2922 AUDREY DR STE 102
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-7268
Practice Address - Country:US
Practice Address - Phone:980-533-0606
Practice Address - Fax:980-243-1951
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-28
Last Update Date:2021-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5906124Q00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No124Q00000XDental ProvidersDental Hygienist