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NPI Code Detail

MEDICARE: BRUCE STUART FIELDMAN, D.M.D., P.C.

MEDICARE: BRUCE STUART FIELDMAN, D.M.D., P.C.
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
11223P0221XPediatric Dentistry13305MA

General Provider Information

NPI Number : 1649323478
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRUCE STUART FIELDMAN, D.M.D., P.C.
Provider Business Mailing Address
First Line : 48 AUBURN ST
Second Line :
City : AUBURN
State : MA
Zip : 01501-2438
Country : US
Telephone Number : 508-832-6278
Fax Number : 508-832-6133
Provider Business Practice Location Address
First Line : 48 AUBURN ST
Second Line :
City : AUBURN
State : MA
Zip : 01501-2438
Country : US
Telephone Number : 508-832-6278
Fax Number : 508-832-6133
Authorized Official
Title or Position : PEDIATRIC DENTIST
Name : DR. BRUCE STUART FIELDMAN
Credential : D.M.D.
Telephone Number : 508-832-6278
Provider Enumeration Date : 01/18/2007
Last Update Date : 08/22/2020

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