Organization
MATTHEW BRIDWELL DDS PA
Active
Other names
Kanis Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW H BRIDWELL DDS (PRESIDENT/DENTIST)
(501) 269-6811
Entity
Organization
Contact information
Practice address
10809 KANIS RD STE 500, LITTLE ROCK, AR 72211-3826
(501) 244-3500
(501) 244-3501
Mailing address
4 SIENNA LAKE CV, LITTLE ROCK, AR 72210-3717
(501) 244-3500
(501) 244-3501
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
AR
Other
Enumeration date
03/12/2013
Last updated
03/12/2013
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