MEDICARE: DR. BRUCE LEONARD BAUMAN D.M.D.

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	122300000X	Dentist	3140	AZ

General Provider Information

NPI Number	:	1780032029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE LEONARD BAUMAN D.M.D.

Provider Business Mailing Address
First Line	:	2550 W UNION HILLS DR
Second Line	:	SUITE 202
City	:	PHOENIX
State	:	AZ
Zip	:	85027-5163
Country	:	US
Telephone Number	:	888-833-8441
Fax Number	:

Provider Business Practice Location Address
First Line	:	2550 W UNION HILLS DR
Second Line	:	SUITE 202
City	:	PHOENIX
State	:	AZ
Zip	:	85027-5163
Country	:	US
Telephone Number	:	888-833-8441
Fax Number	:

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

Provider Enumeration Date	:	05/26/2016
Last Update Date	:	05/26/2016

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