Healthcare Provider Details

I. General information

NPI: 1295887677
Provider Name (Legal Business Name): BRUCE D. SCHULMAN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 09/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10150 HAGEN RANCH RD STE 200
BOYNTON BEACH FL
33437-3776
US

IV. Provider business mailing address

10150 HAGEN RANCH RD STE 200
BOYNTON BEACH FL
33437-3776
US

V. Phone/Fax

Practice location:
  • Phone: 561-738-9777
  • Fax: 561-738-9799
Mailing address:
  • Phone: 561-738-9777
  • Fax: 561-738-9799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDN 0012401
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: