Provider Demographics
NPI:1841525722
Name:BYRNE, BRIDGET ELLEN (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:ELLEN
Last Name:BYRNE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:520 NORTH 12 STREET
Mailing Address - Street 2:ROOM 450 DEAN'S OFFICE
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0566
Mailing Address - Country:US
Mailing Address - Phone:804-828-9184
Mailing Address - Fax:804-828-6072
Practice Address - Street 1:520 N 12TH ST
Practice Address - Street 2:DEAN'S OFFICE ROOM 450
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5064
Practice Address - Country:US
Practice Address - Phone:804-828-9184
Practice Address - Fax:804-828-6072
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010062101223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics