Provider Demographics
NPI:1780682112
Name:FLOOR, BRUCE ARTHUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ARTHUR
Last Name:FLOOR
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 1:1682 WEBSTER DR SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-6411
Mailing Address - Country:US
Mailing Address - Phone:503-581-2136
Mailing Address - Fax:
Practice Address - Street 1:1682 WEBSTER DR SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-6411
Practice Address - Country:US
Practice Address - Phone:503-581-2136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-10
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD47931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR061879Medicaid