Provider Demographics
NPI:1386788677
Name:BRIDGES, LAURA A (DMD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:A
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 STATE ROUTE 34 200
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2416
Mailing Address - Country:US
Mailing Address - Phone:732-946-4244
Mailing Address - Fax:732-946-4492
Practice Address - Street 1:146 STATE ROUTE 34
Practice Address - Street 2:SUITE 200
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-2407
Practice Address - Country:US
Practice Address - Phone:732-946-4244
Practice Address - Fax:732-946-4492
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1016168001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice