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General NPI Number Information
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NPI Number | 1295729325
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Entity Type | Individual
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Provider Name | BRUCE MICHAEL BIEBER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/05/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 21710 73RD AVE
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City | OAKLAND GARDENS
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State | NY
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Zip | 11364-2932
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Country | US
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Telephone | 718-464-7556
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Fax |
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Provider Business Mailing Address
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Address Line | 14 JODY LN
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City | PLAINVIEW
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State | NY
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Zip | 11803-3107
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Country | US
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Telephone | 516-935-0458
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Fax | 516-933-8667
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 037856
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License Number State | NY
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