Bruce A. Bell, DDS

Individual provider Active NPI General Practice Dentistry · Jefferson City, TN

NPI 1376611269 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1376611269
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2751 (TN)
Practice address
683 E Broadway Blvd
Jefferson City, TN 37760-4906
Phone
(865) 475-8331
Fax
(865) 475-4631
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20151013001368 TN Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
4183932783

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2751TNMDEmergency Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2751 TN Yes

Addresses

Primary practice location

683 E Broadway Blvd
Jefferson City, TN 37760-4906

Mailing address

683 E Broadway Blvd
Jefferson City, TN 37760-4906
Phone (865) 475-8331

Other providers in Jefferson City, TN

All providers in Jefferson City, TN · General Practice Dentistry in Tennessee

Sources for this page

Verify at the official NPI Registry.