Organization
BFD MADISONVILLE ASSOCIATES LLC
Active
Other names
Bridgelake Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MARK TINNEY DDS (OWNER/DENTIST)
(985) 590-5175
Entity
Organization
Contact information
Practice address
109 PINE CREEK DRIVE, SUITE B, MADISONVILLE, LA 70447
(985) 590-5175
(985) 590-5165
Mailing address
109 PINE CREEK DRIVE, SUITE B, MADISONVILLE, LA 70447
(985) 590-5175
(985) 590-5165
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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