Provider Demographics
NPI:1700848744
Name:HARTMAN, BRUCE A JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:A
Last Name:HARTMAN
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-2072
Mailing Address - Country:US
Mailing Address - Phone:610-377-1080
Mailing Address - Fax:
Practice Address - Street 1:155 S 2ND ST
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-2072
Practice Address - Country:US
Practice Address - Phone:610-377-1080
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS28923L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice