Organization
LIFE BRIDGE DENTAL DC PLLC
Active
Other names
Tend Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH NEIL SULLIVAN (DIRECTOR OF PATIENT REVENUE)
(212) 686-3686
Entity
Organization
Contact information
Practice address
600 PENNSYLVANIA AVE NW, WASHINGTON, DC 20580-0001
(212) 686-3686
(615) 468-0325
Mailing address
5505 N CUMBERLAND AVE STE 307, CHICAGO, IL 60656-4761
(212) 686-3686
(615) 468-0325
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/18/2021
Last updated
03/18/2021
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