# MPDA BRIDGEPORT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bridgeport Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336966795
- **Authorized official:** BENJAMIN LASHLEY DDS (PARTNER)
- **Authorized official phone:** (308) 534-1289

## Contact information

- **Practice address:** 1006 MAIN ST, BRIDGEPORT, NE 69336-4035
- **Practice address phone:** (308) 262-1434
- **Mailing address:** 1006 MAIN ST, BRIDGEPORT, NE 69336-4035
- **Mailing address phone:** (308) 262-1434

## Taxonomy

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

## Other

- **Enumeration date:** 09/25/2024
- **Last updated:** 09/25/2024