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General NPI Number Information
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NPI Number | 1578282786
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Entity Type | Individual
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Provider Name | RACHAEL BRUCE
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Gender | Female
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 2100 16TH AVE S
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City | GREAT FALLS
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State | MT
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Zip | 59405-4907
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Country | US
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Telephone | 406-771-4365
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Fax |
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Provider Business Mailing Address
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Address Line | 35 SPRING RIDGE DR
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City | GREAT FALLS
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State | MT
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Zip | 59404-6483
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Country | US
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Telephone |
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Fax |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 1355
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License Number State | MT
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