Provider Demographics
NPI:1811989403
Name:OKUN, BRUCE F (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:F
Last Name:OKUN
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 1:8263 S PECAN GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-2311
Mailing Address - Country:US
Mailing Address - Phone:480-838-6695
Mailing Address - Fax:480-967-6050
Practice Address - Street 1:1050 E SOUTHERN AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5403
Practice Address - Country:US
Practice Address - Phone:480-967-8763
Practice Address - Fax:480-967-6050
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice