Provider Demographics
NPI:1720379373
Name:BUER, BRUCE HOLLIS (DMD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:HOLLIS
Last Name:BUER
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 1:2300 12TH AVE S
Mailing Address - Street 2:SUITE #109
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-5017
Mailing Address - Country:US
Mailing Address - Phone:406-761-1837
Mailing Address - Fax:406-761-1890
Practice Address - Street 1:2300 12TH AVE S
Practice Address - Street 2:SUITE #109
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5017
Practice Address - Country:US
Practice Address - Phone:406-761-1837
Practice Address - Fax:406-761-1890
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1551122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist