Bruce K.a. Dormanen, P.a.

NPI 1316035595 - Dentist - 1223X0400X

NPI Details
NPI 1316035595
Enumeration Date 10/11/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name BRUCE K.A. BRUCE
Position CEO
Phone (763) 421-9292
Fax (763) 421-7559
Practice Location
2150 3RD AVE STE 200
ANOKA MN, 55303-2200, US
Phone (763) 421-9292
Fax (763) 421-7559
Business Location
2150 3RD AVE STE 200
ANOKA MN, 55303-2200, US
Phone (763) 421-9292
Fax (763) 421-7559
Toxanomy
Taxonomy Code 1223X0400X
License State Minnesota
License Number 8151
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According to our database, Bruce K.a. Dormanen, P.a. NPI is 1316035595, taxonomy code is 1223X0400X and license number is 8151, license state is located at Minnesota. Bruce K.a. Dormanen, P.a. physically located at 2150 3rd Ave Ste 200, Anoka MN, 55303-2200. NPI Number 1033115704 has the healthcare provider type.

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1316035595 NPI number is provided on an as is basis without warranty of any kind. 1316035595 is maintained by the National Plan & Provider Enumeration System. The contents of Bruce K.a. Dormanen, P.a. are for informational purposes only.