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General NPI Number Information
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NPI Number | 1013454461
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Entity Type | Organization
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Legal Business Name | BRUCE N. LEIN DDS, PA
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Dates
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Enumeration Date | 01/24/2017
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Last Update Date | 02/10/2017
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Provider Practice Location Address
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Address Line | 825 S US HIGHWAY 1 SUITE 250
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City | JUPITER
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State | FL
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Zip | 33477-5976
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Country | US
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Telephone | 561-744-6121
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Fax | 561-401-9367
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Provider Business Mailing Address
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Address Line | 825 S US HIGHWAY 1 SUITE 250
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City | JUPITER
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State | FL
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Zip | 33477-5976
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Country | US
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Telephone | 561-744-6121
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Fax | 561-401-9367
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Authorized Official
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Title or Position | DDS - OWNER
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Name | BRUCE N LEIN
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Credential |
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Telephone | 561-744-6121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN 17633
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License Number State | FL
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