Provider Demographics
NPI:1154488526
Name:BITZER, BRUCE WALTER (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:WALTER
Last Name:BITZER
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 1:385 S MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-1543
Mailing Address - Country:US
Mailing Address - Phone:201-201-6520
Mailing Address - Fax:201-652-0004
Practice Address - Street 1:385 S MAPLE AVE
Practice Address - Street 2:
Practice Address - City:GLEN ROCK
Practice Address - State:NJ
Practice Address - Zip Code:07452-1543
Practice Address - Country:US
Practice Address - Phone:201-201-6520
Practice Address - Fax:201-652-0004
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI015758001223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics