NPI 1225274681

Bridgeport Dental Services, INC.

Organisation Health Maintenance Organization Saint Charles, MO

Practice location

Address: 12 Westbury Dr Suite D, Saint Charles, MO 63301-2543
Phone: (636) 925-2787
Fax: (636) 925-2829

Authorised official

Name: Kristine Usry
Title: Manager of Finance
Phone: (636) 925-2787

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 010435 (MO)

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Registry record

NPI: 1225274681
Entity type: Organization
NPI issued: 6 Jan 2009
Record last updated: 6 Jan 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.