# BRIDGE STREET DENTAL, PLLC

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

## Provider details

- **NPI number:** 1306347182
- **Authorized official:** DR. TRAVIS WHITELEY DMD (PRESIDENT)
- **Authorized official phone:** (801) 376-9484

## Contact information

- **Practice address:** 19 N 42ND AVE, BRIGHTON, CO 80601-4351
- **Practice address phone:** (720) 583-1425
- **Mailing address:** 19 N 42ND AVE, BRIGHTON, CO 80601-4351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 8920 | CO | Yes |

## Other

- **Enumeration date:** 02/26/2018
- **Last updated:** 02/26/2018