Provider Demographics
NPI:1881896231
Name:BRIDGES, THOMAS C (DDS)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:C
Last Name:BRIDGES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 POST ST STE 1010
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4913
Mailing Address - Country:US
Mailing Address - Phone:415-397-1010
Mailing Address - Fax:415-398-1011
Practice Address - Street 1:360 POST ST STE 1010
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4913
Practice Address - Country:US
Practice Address - Phone:415-397-1010
Practice Address - Fax:415-398-1011
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA456531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice