Bridges, Iii, George I. Trace

Bridges, Iii, George I. Trace is an sole proprietor health care provider with primary practice located at 2928 Nw Cache Rd , Lawton OK 73505-3827. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Bridges, Iii, George I. Trace can be contacted via phone (580) 355-8300.

Contact Information

Primary practice address
2928 Nw Cache Rd Lawton OK 73505-3827
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 5215 Oklahoma

Profile Details

NPI number 1275546970
LBN Legal business name Bridges, Iii, George I. Trace
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 14th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275546970 NPPES
Pennsylvania Other 860044 UNITED CONCORDIA
Pennsylvania Other 203345893001 UNITED CONCORDIA

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