Organization
BLUE BRIDGE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANY KIMMEL DDS (CEO)
(570) 847-7815
Entity
Organization
Contact information
Practice address
11160 W.J. PRESLEY PKWY, SUITE 200, ALLENDALE, MI 49401
(616) 217-3992
Mailing address
11160 W.J. PRESLEY PKWY, SUITE 200, ALLENDALE, MI 49401
(616) 217-3992
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/10/2022
Last updated
11/10/2022
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