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Individual
BRUCE P. MANDEL
Active
Individual
BRUCE P. MANDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
6980
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6980
DENTAL LICENSE
MD
Enumeration date
03/29/2007
Last updated
07/08/2007
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