# BRIDGE STREET SMILES, PLLC

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

## Provider details

- **NPI number:** 1316767163
- **Authorized official:** DR. RENEE LYN-IREY OWEN DDS (OWNER)
- **Authorized official phone:** (517) 526-1234

## Contact information

- **Practice address:** 119 E BRIDGE ST, PORTLAND, MI 48875-1434
- **Practice address phone:** (517) 647-4511
- **Mailing address:** 9645 TOWNER RD, PORTLAND, MI 48875-9481
- **Mailing address phone:** (517) 526-1234

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/16/2024
- **Last updated:** 10/16/2024