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General NPI Number Information
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NPI Number | 1649323478
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Entity Type | Organization
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Legal Business Name | BRUCE STUART FIELDMAN, D.M.D., P.C.
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 48 AUBURN ST
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City | AUBURN
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State | MA
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Zip | 01501-2438
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Country | US
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Telephone | 508-832-6278
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Fax | 508-832-6133
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Provider Business Mailing Address
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Address Line | 48 AUBURN ST
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City | AUBURN
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State | MA
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Zip | 01501-2438
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Country | US
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Telephone | 508-832-6278
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Fax | 508-832-6133
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. BRUCE STUART FIELDMAN
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Credential | D.M.D.
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Telephone | 508-832-6278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 13305
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License Number State | MA
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