MEDICARE: BRUCE QUESADA RDH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	DH.002027407	CO

General Provider Information

NPI Number	:	1023944741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE QUESADA RDH

Provider Business Mailing Address
First Line	:	2506 W COLFAX AVE APT 731
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-2854
Country	:	US
Telephone Number	:	908-514-6477
Fax Number	:

Provider Business Practice Location Address
First Line	:	2506 W COLFAX AVE APT 731
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-2854
Country	:	US
Telephone Number	:	908-514-6477
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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