Organization
BRIDGE FAMILY DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIOLETTA THIERBACH D.D.S (OWNER)
(718) 833-1847
Entity
Organization
Contact information
Practice address
8116 3RD AVE, BROOKLYN, NY 11209-3860
(718) 833-1847
(718) 833-1854
Mailing address
8116 3RD AVE, BROOKLYN, NY 11209-3860
(718) 833-1847
(718) 833-1854
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
047807
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02128678
—
NY
Enumeration date
10/17/2012
Last updated
10/17/2012
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