Individual
LYDIA JULIANNA BRUCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
527 N GROVE ST, WICHITA, KS 67214-4520
(316) 262-2415
Mailing address
3944 N RUSHWOOD ST, WICHITA, KS 67226-2427
(405) 564-8849
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61864
KS
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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