Individual
DR. BRUCE THOMPSON BLEIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
15465 OAK LANE, STE. 100 - H, GULFPORT, MS 39503-3524
(228) 832-4450
(228) 832-4550
Mailing address
12210 LAKE FOREST DR, GULFPORT, MS 39503-5603
(228) 832-0089
(228) 832-0089
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1475-72
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01831829
—
MS
Enumeration date
02/25/2008
Last updated
01/20/2011
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