Provider Demographics
NPI:1144391798
Name:LANKE, BRUCE D (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:D
Last Name:LANKE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5875 LANDERBROOK DR STE 250
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-6502
Mailing Address - Country:US
Mailing Address - Phone:800-487-4867
Mailing Address - Fax:216-593-7533
Practice Address - Street 1:1000 PARK MANOR BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-4800
Practice Address - Country:US
Practice Address - Phone:412-788-0877
Practice Address - Fax:412-788-0938
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-024405L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice