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General NPI Number Information
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NPI Number | 1598860421
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Entity Type | Individual
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Provider Name | BRUCE ELLINGTON YUILLE DDS
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 700 GEIPE ROAD SUITE 270
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City | CANTONSVILLE
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State | MD
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Zip | 21228-4147
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Country | US
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Telephone | 410-566-1550
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Fax | 410-744-0167
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Provider Business Mailing Address
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Address Line | 9637 WOODLAND ROAD
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City | NEW MARKET
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State | MD
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Zip | 21774-2942
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Country | US
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Telephone | 301-865-4811
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D01811
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License Number State | MD
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