Provider Demographics
NPI:1255407326
Name:BRUCE, RICHARD THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:THOMAS
Last Name:BRUCE
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 1:3501 W CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3704
Mailing Address - Country:US
Mailing Address - Phone:610-356-2533
Mailing Address - Fax:610-356-1148
Practice Address - Street 1:3501 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3704
Practice Address - Country:US
Practice Address - Phone:610-356-2533
Practice Address - Fax:610-356-1148
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-023184L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice