Bruce Nelson Anderson, D.M.D.
Individual provider Active NPI General Practice Dentistry · Wareham, MA
NPI 1649464207 · NPPES record last updated Aug 28, 2007
Key facts
- NPI
- 1649464207
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12626 (MA)
- Practice address
- 16 Highland Rd
Wareham, MA 02571-1409 - Phone
- (508) 728-9818
- NPI assigned
- Aug 28, 2007
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 12626 | MA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12626 | MA | Yes |
Addresses
Primary practice location
16 Highland Rd
Wareham, MA 02571-1409
Mailing address
PO Box 473
Mattapoisett, MA 02739-0473
Phone (508) 728-9818
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0243973 | Medicaid | MA |
Other providers in Wareham, MA
- Toni Aiduk
- Katie Maureen Akley
- Ashley L Albano
- Pilar Alonso
- Amy Gleason Wiegandt
- Michelle L Anderson
- Wendell Gross Anderson
- Dante Jay Andrade
- Shannon Joy Antonio
- Aras House of Beauty
All providers in Wareham, MA · General Practice Dentistry in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.