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NPI Code Detail

MEDICARE: DR. BRUCE E. STEWART D.D.S.

MEDICARE: DR. BRUCE E. STEWART D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry13831MI
21223G0001XGeneral Practice DentistryD07912AZ
31223G0001XGeneral Practice Dentistry9269KY

General Provider Information

NPI Number : 1790758860
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRUCE E. STEWART D.D.S.
Provider Business Mailing Address
First Line : 1010 MAIN ST S
Second Line :
City : MC KEE
State : KY
Zip : 40447-7089
Country : US
Telephone Number : 859-626-7700
Fax Number : 859-626-7890
Provider Business Practice Location Address
First Line : 1010 MAIN ST S
Second Line :
City : MC KEE
State : KY
Zip : 40447-7089
Country : US
Telephone Number : 606-287-7104
Fax Number : 606-287-3323
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2006
Last Update Date : 03/17/2018

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