Bruce R Bragdon, DMD
Individual provider Active NPI General Practice Dentistry · Durham, NH
NPI 1891737599 · NPPES record last updated May 29, 2008
Key facts
- NPI
- 1891737599
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 1375 (NH)
- Practice address
- 10 Mathes Ter
Durham, NH 03824-2302 - Phone
- (603) 868-5129
- Fax
- (603) 868-5142
- NPI assigned
- Jun 10, 2006
- 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 |
|---|---|---|---|
| 1375 | NH | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1375 | NH | Yes |
Addresses
Primary practice location
10 Mathes Ter
Durham, NH 03824-2302
Mailing address
10 Mathes Ter
Durham, NH 03824-2302
Phone (603) 868-5129
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89191854 | Medicaid | NH |
Other providers in Durham, NH
- Better Self Better Life, P.L.L.C.
- Mark R Blackwood
- Rebecca Blake
- Erika Louise Blocher
- Bragdon Dugas & Rutter PC
- Katharina Rae Brandt
- Lessa Ann Brill
- Dennis Patrick Brooks
- Bruce R Bragdon DMD
- C. Patricia Hanley, PH.D PLLC
All providers in Durham, NH · General Practice Dentistry in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2008. 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.