# BRIDGE ORAL-FACIAL SURGERY AND IMPLANT CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275961815
- **Authorized official:** DR. BRIAN F BOVINO DMD (PARTNER)
- **Authorized official phone:** (201) 585-9800

## Contact information

- **Practice address:** 2029 LEMOINE AVE, SUITE 103, FORT LEE, NJ 07024-5704
- **Practice address phone:** (201) 585-9800
- **Practice address fax:** (201) 585-9820
- **Mailing address:** 2029 LEMOINE AVE, SUITE 103, FORT LEE, NJ 07024-5704
- **Mailing address phone:** (201) 585-9800
- **Mailing address fax:** (201) 585-9820

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 015109 | NJ | Yes |

## Other

- **Enumeration date:** 10/16/2013
- **Last updated:** 10/16/2013