Provider Demographics
NPI:1700050606
Name:KUWANO, BRUCE (DDS)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:
Last Name:KUWANO
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 1:17705 HALE AVE STE E3
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-4346
Mailing Address - Country:US
Mailing Address - Phone:408-778-3015
Mailing Address - Fax:
Practice Address - Street 1:17705 HALE AVE STE E3
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-4346
Practice Address - Country:US
Practice Address - Phone:408-778-3015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43998122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist