Bruce M Pope, DDS

Individual provider Active NPI General Practice Dentistry · Live Oak, CA

NPI 1538162425 · NPPES record last updated Jul 11, 2019

Key facts

NPI
1538162425
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
29423 (CA)
Practice address
9900 Larkin Rd
Live Oak, CA 95953-2442
Phone
(530) 695-1884
Fax
(530) 695-1994
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
29423CAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 29423 CA Yes

Addresses

Primary practice location

9900 Larkin Rd
Live Oak, CA 95953-2442

Mailing address

9900 Larkin Rd
Live Oak, CA 95953-2442
Phone (530) 695-1884

Other providers in Live Oak, CA

All providers in Live Oak, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.