Provider Demographics
NPI:1164437539
Name:WETMORE, BRUCE C (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:C
Last Name:WETMORE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:80 GARDEN CTR
Mailing Address - Street 2:SUITE 223
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-7087
Mailing Address - Country:US
Mailing Address - Phone:303-465-2308
Mailing Address - Fax:303-465-2309
Practice Address - Street 1:80 GARDEN CTR
Practice Address - Street 2:SUITE 223
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-7087
Practice Address - Country:US
Practice Address - Phone:303-465-2308
Practice Address - Fax:303-465-2309
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO71871223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery