Provider Demographics
NPI:1104944602
Name:WENTWORTH BRIDGES, LINDA W (DDS)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:W
Last Name:WENTWORTH BRIDGES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HALTON GREEN WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-6606
Mailing Address - Country:US
Mailing Address - Phone:864-283-2838
Mailing Address - Fax:864-286-0560
Practice Address - Street 1:4 HALTON GREEN WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6606
Practice Address - Country:US
Practice Address - Phone:864-283-2838
Practice Address - Fax:864-286-0560
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice