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Organization
BRUCE B. WILAND, DDS, MSD
Active
Organization
BRUCE B. WILAND, DDS, MSD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE WILAND DDS, MSD (OWNER)
(765) 864-0700
Entity
Organization
Contact information
Practice address
3415 S LAFOUNTAIN ST STE K, KOKOMO, IN 46902-3827
(765) 864-0700
Mailing address
3415 S LAFOUNTAIN ST STE K, KOKOMO, IN 46902-3827
(765) 864-0700
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
12008945
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100132270
—
IN
Enumeration date
11/21/2008
Last updated
11/21/2008
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