Organization
J MACMILLAN BRUCE DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHAEL K BRUCE (OFFICE MANAGER)
(208) 323-7999
Entity
Organization
Contact information
Practice address
1744 N MITCHELL ST, BOISE, ID 83704
(208) 323-7999
(208) 322-5662
Mailing address
1744 N MITCHELL ST, BOISE, ID 83704
(208) 323-7999
(208) 322-5662
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3713
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806659200
—
ID
Enumeration date
05/14/2008
Last updated
05/14/2008
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