Organization
MPDA BRIDGEPORT LLC
Active
Other names
Bridgeport Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN LASHLEY DDS (PARTNER)
(308) 534-1289
Entity
Organization
Contact information
Practice address
1006 MAIN ST, BRIDGEPORT, NE 69336-4035
(308) 262-1434
Mailing address
1006 MAIN ST, BRIDGEPORT, NE 69336-4035
(308) 262-1434
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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