Provider Demographics
NPI:1760583009
Name:JIORLE, BRUCE JOHN (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:JOHN
Last Name:JIORLE
Suffix:
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 1:835 BELVIDERE RD
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1384
Mailing Address - Country:US
Mailing Address - Phone:908-859-4555
Mailing Address - Fax:908-859-0487
Practice Address - Street 1:835 BELVIDERE RD
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1384
Practice Address - Country:US
Practice Address - Phone:908-859-4555
Practice Address - Fax:908-859-0487
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI011709001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics