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Individual

DR. BRUCE D MARZULLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
43 LAGRANGE AVENUE, POUGHKEEPSIE, NY 12603
(845) 452-2900
(845) 452-4974
Mailing address
43 LAGRANGE AVENUE, POUGHKEEPSIE, NY 12603
(845) 452-2900
(845) 452-4974

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
037383
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01017770
NY
Enumeration date
02/07/2007
Last updated
03/07/2023
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