Organization
NORTHBRIDGE DENTAL, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA HARTRIDGE (OFFICE MANAGER)
(678) 319-0210
Entity
Organization
Contact information
Practice address
11060 ALPHARETTA HWY, SUITE #162, ROSWELL, GA 30076-1472
(678) 352-9890
(678) 352-9892
Mailing address
11060 ALPHARETTA HWY, SUITE #162, ROSWELL, GA 30076-1472
(678) 352-9890
(678) 352-9892
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
011752
GA
302R00000X
Health Maintenance Organization
Primary
011781
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
519326539B
—
GA
05
—
734279204C
—
GA
Enumeration date
09/16/2008
Last updated
09/16/2008
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