Provider Demographics
NPI:1659454197
Name:SMOLER, BRUCE AARON (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:AARON
Last Name:SMOLER
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 1:820 N WAYNE RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-3632
Mailing Address - Country:US
Mailing Address - Phone:734-728-5600
Mailing Address - Fax:734-728-1656
Practice Address - Street 1:820 N WAYNE RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-3632
Practice Address - Country:US
Practice Address - Phone:734-728-5600
Practice Address - Fax:734-728-1656
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI014894122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist