Provider Demographics
NPI:1518976968
Name:KINDER, BRUCE BOWMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:BOWMAN
Last Name:KINDER
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 1:903 SOUTH EVANSTON CIRCLE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012
Mailing Address - Country:US
Mailing Address - Phone:303-903-7200
Mailing Address - Fax:303-856-3700
Practice Address - Street 1:903 SOUTH EVANSTON CIRCLE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012
Practice Address - Country:US
Practice Address - Phone:303-903-7200
Practice Address - Fax:303-856-3700
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1052491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1437472438Medicaid