MEDICARE: DR. WILLIAM E BRUCE II DMD

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	1223G0001X	General Practice Dentistry	571097582	SC

General Provider Information

NPI Number	:	1508920133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM E BRUCE II DMD

Provider Business Mailing Address
First Line	:	672 FAIRVIEW RD
Second Line	:
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29680-6708
Country	:	US
Telephone Number	:	864-962-5522
Fax Number	:

Provider Business Practice Location Address
First Line	:	672 FAIRVIEW RD
Second Line	:
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29680-6708
Country	:	US
Telephone Number	:	864-962-5522
Fax Number	:

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

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	05/27/2014

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