Organization
BRIDGE FAMILY DENTAL GRP PA
Active
Other names
Charles D Lott DMD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES D LOTT DMD (PRESIDENT)
(908) 782-4418
Entity
Organization
Contact information
Practice address
15 N BRIDGE ST, SOMERVILLE, NJ 08876-2110
(908) 725-0400
(908) 725-1148
Mailing address
820 RTE 202 N, NESHANIC STATION, NJ 08853
(908) 782-4418
(908) 782-8661
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22D1009270 01
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1904906
—
NJ
Enumeration date
12/20/2006
Last updated
08/22/2020
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