Provider Demographics
NPI:1003992314
Name:GOPIN, BRUCE WILLIAM (DDS)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:WILLIAM
Last Name:GOPIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9398 VISCOUNT BLVD
Mailing Address - Street 2:SUITE 5C
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-8056
Mailing Address - Country:US
Mailing Address - Phone:915-533-4608
Mailing Address - Fax:
Practice Address - Street 1:9398 VISCOUNT BLVD
Practice Address - Street 2:SUITE 5C
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-8056
Practice Address - Country:US
Practice Address - Phone:915-533-4608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX168331223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics