# BRIDGE FAMILY DENTAL GRP PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Charles D Lott DMD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568526291
- **Authorized official:** DR. CHARLES D LOTT DMD (PRESIDENT)
- **Authorized official phone:** (908) 782-4418

## Contact information

- **Practice address:** 15 N BRIDGE ST, SOMERVILLE, NJ 08876-2110
- **Practice address phone:** (908) 725-0400
- **Practice address fax:** (908) 725-1148
- **Mailing address:** 820 RTE 202 N, NESHANIC STATION, NJ 08853
- **Mailing address phone:** (908) 782-4418
- **Mailing address fax:** (908) 782-8661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22D1009270 01 | NJ | Yes |

## Other

- **Enumeration date:** 12/20/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1904906 | — | NJ |