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General NPI Number Information
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NPI Number | 1154798650
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Entity Type | Organization
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Legal Business Name | BRUCE M KERN DMD DENTIST PC
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Dates
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Enumeration Date | 08/31/2015
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 1600 PERRINEVILLE RD
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City | MONROE TOWNSHIP
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State | NJ
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Zip | 08831-4923
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Country | US
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Telephone | 609-409-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 PERRINEVILLE RD
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City | MONROE TOWNSHIP
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State | NJ
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Zip | 08831-4923
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Country | US
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Telephone | 609-409-9700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRUCE MICHAEL KERN
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Credential | DMD
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Telephone | 609-409-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 22DI01741100
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License Number State | NJ
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