Organization
LIFE BRIDGE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH NEILQ SULLIVAN (DIRECTOR, RCM)
(212) 686-3686
Entity
Organization
Contact information
Practice address
11564 OLD GEORGETOWN ROAD, NORTH BETHESDA, MD 20852
(212) 686-3686
(615) 468-0325
Mailing address
8 CITY BLVD STE 203, NASHVILLE, TN 37209-2559
(212) 686-3686
(615) 468-0325
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/05/2022
Last updated
05/05/2022
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