Provider Demographics
NPI:1194752782
Name:MCBRIDE, LINDA D (DDS)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:D
Last Name:MCBRIDE
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 1:6103 QUAIL DR
Mailing Address - Street 2:
Mailing Address - City:PORT NORRIS
Mailing Address - State:NJ
Mailing Address - Zip Code:08349-3535
Mailing Address - Country:US
Mailing Address - Phone:856-785-7030
Mailing Address - Fax:856-785-7030
Practice Address - Street 1:70 COHANSEY ST
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-1918
Practice Address - Country:US
Practice Address - Phone:856-451-4700
Practice Address - Fax:856-451-0029
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI01773203122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist