Organization · NPI-2

Bridgewater Family Dental

Dentist, General Practice · Bridgewater, NJ

NPI number1710240858
StatusActive
Last updated in NPPESJul 30, 2015

Details

NPI
1710240858
Entity type
Organization (NPI-2)
Legal business name
Bridgewater Family Dental
Organization subpart
No
Enumeration date
Jun 22, 2012
Last updated
Jul 30, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice22DI020751NJYes
1223E0200X Dentist, Endodontics22 DI 02249700NJ
1223G0001X Dentist, General Practice22 DI 02312200NJ

Practice location

676 Route 202/206
Bridgewater, NJ 08807-1761

Phone 908-722-6666 · Fax 908-722-6667

Mailing address

676 Route 202/206
Bridgewater, NJ 08807-1761

Phone 908-722-6666 · Fax 908-722-6667

Authorized official

Marwan Bassil Bassil
Owner
9087226666

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