Provider Demographics
NPI:1932264678
Name:BARAL, BRUCE R (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:R
Last Name:BARAL
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 1:6514 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1554
Mailing Address - Country:US
Mailing Address - Phone:562-420-8578
Mailing Address - Fax:562-420-7327
Practice Address - Street 1:6514 E SPRING ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1554
Practice Address - Country:US
Practice Address - Phone:562-420-8578
Practice Address - Fax:562-420-7327
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA285141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice