Healthcare Provider Details

I. General information

NPI: 1891958203
Provider Name (Legal Business Name): ARTHUR L. BRUCE, DMD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

896 S MECHANIC ST
PENDLETON SC
29670-1813
US

IV. Provider business mailing address

896 S MECHANIC ST
PENDLETON SC
29670-1813
US

V. Phone/Fax

Practice location:
  • Phone: 864-646-7152
  • Fax: 864-646-7112
Mailing address:
  • Phone: 864-646-7152
  • Fax: 864-646-7112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2093
License Number StateSC

VIII. Authorized Official

Name: MRS. KATHY Z BRUCE
Title or Position: OFFICE MANAGER
Credential:
Phone: 864-646-7152