Provider Demographics
NPI:1922125632
Name:THIBODAUX, BRIDGET COMFORT (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:COMFORT
Last Name:THIBODAUX
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8680 BLUEBONNET BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-7825
Mailing Address - Country:US
Mailing Address - Phone:225-757-8700
Mailing Address - Fax:225-757-8777
Practice Address - Street 1:8680 BLUEBONNET BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-7825
Practice Address - Country:US
Practice Address - Phone:225-757-8700
Practice Address - Fax:225-757-8777
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA50641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice