Provider Demographics
NPI:1639247851
Name:BRUCE, ALICE ABRERA (DDS)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:ABRERA
Last Name:BRUCE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 LOS PADRES BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4462
Mailing Address - Country:US
Mailing Address - Phone:408-244-3867
Mailing Address - Fax:408-244-4049
Practice Address - Street 1:1500 LOS PADRES BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4462
Practice Address - Country:US
Practice Address - Phone:408-244-3867
Practice Address - Fax:408-244-4049
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40543122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist