Provider Demographics
NPI:1598860421
Name:YUILLE, BRUCE ELLINGTON (DDS)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:ELLINGTON
Last Name:YUILLE
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 1:9637 WOODLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-2942
Mailing Address - Country:US
Mailing Address - Phone:301-865-4811
Mailing Address - Fax:
Practice Address - Street 1:700 GEIPE ROAD
Practice Address - Street 2:SUITE 270
Practice Address - City:CANTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4147
Practice Address - Country:US
Practice Address - Phone:410-566-1550
Practice Address - Fax:410-744-0167
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD018111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice