Provider Demographics
NPI:1558496042
Name:ARNE', BRUCE
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:
Last Name:ARNE'
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7506
Mailing Address - Country:US
Mailing Address - Phone:910-762-1555
Mailing Address - Fax:910-251-1721
Practice Address - Street 1:1510 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7506
Practice Address - Country:US
Practice Address - Phone:910-762-1555
Practice Address - Fax:910-251-1721
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC66491223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC010709135OtherTAX ID
NC010709135OtherTAX ID
NCU92353Medicare UPIN