Healthcare Provider Details

I. General information

NPI: 1831363142
Provider Name (Legal Business Name): BRUCE C ARNE' DDS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 MEDICAL CENTER DR
WILMINGTON NC
28401
US

IV. Provider business mailing address

1510 MEDICAL CENTER DR
WILMINGTON NC
28401
US

V. Phone/Fax

Practice location:
  • Phone: 910-762-1555
  • Fax: 910-251-1721
Mailing address:
  • Phone: 910-762-1555
  • Fax: 910-251-1721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number StateNC

VIII. Authorized Official

Name: CATHY PETERSON
Title or Position: MS
Credential:
Phone: 910-762-1555