Individual
DR. BRUCE BRIAN HORSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DDS
Contact information
Practice address
830 PENNSYLVANIA AVE, SUITE 302, CHARLESTON, WV 25302-3302
(304) 388-2950
(304) 388-2951
Mailing address
830 PENNSYLVANIA AVE 302, CHARLESTON, WV 25302-3390
(304) 388-2950
(304) 388-2951
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
3483
WV
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
20528
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190009986
RAILROAD MEDICARE
—
05
—
3002311000
—
WV
05
—
4002072000
—
WV
Enumeration date
04/13/2006
Last updated
12/21/2015
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