Provider Demographics
NPI:1770605511
Name:BRIDGEMAN, ROBERT CRAIG (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CRAIG
Last Name:BRIDGEMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 MAPLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-8694
Mailing Address - Country:US
Mailing Address - Phone:828-264-2733
Mailing Address - Fax:
Practice Address - Street 1:2348 HIGHWAY 105
Practice Address - Street 2:SUITE1
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-7802
Practice Address - Country:US
Practice Address - Phone:828-264-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC41751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice