| Bridge Lake Dental | |
|
1799 North Kiowa Blvd Unit 109 Lake Havasu AZ 86403 | |
| (928) 399-7711 | |
| (928) 399-7710 |
| Full Name | Bridge Lake Dental |
|---|---|
| Speciality | Dentist |
| Location | 1799 North Kiowa Blvd, Lake Havasu, Arizona |
| Authorized Official Name and Position | Roland Pischinger (INSURANCE DEPARTMENT MANAGER) |
| Authorized Official Contact | 7025222028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridge Lake Dental 2101 S Jones Blvd Ste 140 Las Vegas NV 89146-3133 Ph: (702) 522-2025 | Bridge Lake Dental 1799 North Kiowa Blvd Unit 109 Lake Havasu AZ 86403 Ph: (928) 399-7711 |
| NPI Number | 1912301425 |
|---|---|
| Provider Enumeration Date | 10/13/2014 |
| Last Update Date | 05/31/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912301425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |