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General NPI Number Information
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NPI Number | 1760882591
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Entity Type | Organization
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Legal Business Name | MONICA BRUCE, D.D.S., INC
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Dates
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Enumeration Date | 08/29/2014
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Last Update Date | 08/29/2014
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Provider Practice Location Address
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Address Line | 3756 SANTA ROSALIA DR SUITE 204
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City | LOS ANGELES
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State | CA
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Zip | 90008-3606
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Country | US
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Telephone | 323-293-7225
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Fax | 323-293-7248
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Provider Business Mailing Address
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Address Line | 3756 SANTA ROSALIA DR SUITE 204
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City | LOS ANGELES
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State | CA
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Zip | 90008-3606
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Country | US
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Telephone | 323-293-7225
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Fax | 323-293-7248
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | MONICA BRUCE
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Credential | D.D.S.
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Telephone | 323-293-7225
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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 | 42527
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License Number State | CA
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