MEDICARE: DR. BRUCE CRAIG BREDBECK DDS

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
1	122300000X	Dentist	D15377	MN
2	1223G0001X	General Practice Dentistry	5442	CO

General Provider Information

NPI Number	:	1841291523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE CRAIG BREDBECK DDS

Provider Business Mailing Address
First Line	:	4273 W CIRCLE DR NW STE 311
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55901-8788
Country	:	US
Telephone Number	:	303-773-2273
Fax Number	:	303-713-9887

Provider Business Practice Location Address
First Line	:	4273 W CIRCLE DR NW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55901-8788
Country	:	US
Telephone Number	:	217-540-8386
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	10/20/2025

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