Organization
FAMILY HEALTH CENTERS
Active
Other names
FHC Bridgeport Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JESUS HERNANDEZ (CEO)
(509) 422-5700
Entity
Organization
Contact information
Practice address
1015 COLUMBIA, BRIDGEPORT, WA 98813
(509) 686-0603
(509) 686-0610
Mailing address
PO BOX 1340, OKANOGAN, WA 98840-1340
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/27/2014
Last updated
01/19/2021
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