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Organization
BRIDGEPORT DENTAL SERVICES, INC.
Active
Organization
BRIDGEPORT DENTAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE USRY (MANAGER OF FINANCE)
(636) 925-2787
Entity
Organization
Contact information
Practice address
12 WESTBURY DR, SUITE D, SAINT CHARLES, MO 63301-2543
(636) 925-2787
(636) 925-2829
Mailing address
12 WESTBURY DR, SUITE D, SAINT CHARLES, MO 63301-2543
(636) 925-2787
(636) 925-2829
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
010435
MO
Other
Enumeration date
01/06/2009
Last updated
01/06/2009
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