Individual
DR. BRUCE T. GREENWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
125 S. 10TH E., MOUNTAIN HOME, ID 83647-3120
(208) 587-4326
(208) 587-8607
Mailing address
125 SOUTH 10TH EAST, MOUNTAIN HOME, ID 83647-3120
(208) 587-4326
(208) 587-8607
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3306
ID
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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