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General NPI Number Information
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NPI Number | 1265704480
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Entity Type | Organization
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Legal Business Name | ROBERT BRUCE KING DMD , PC
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 8000 MOFFAT RD.
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City | SEMMES
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State | AL
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Zip | 36575-0748
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Country | US
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Telephone | 251-649-7050
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 748
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City | SEMMES
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State | AL
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Zip | 36575-0748
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Country | US
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Telephone | 251-649-7050
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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. ROBERT BRUCE KING
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Credential | DMD
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Telephone | 251-649-7050
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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 | AL4100
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License Number State | AL
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