Individual
DR. BRUCE WARREN GARRETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
626 SUMMIT, MEXICO, MO 65265
(573) 581-3121
Mailing address
626 SUMMIT, MEXICO, MO 65265
(573) 581-3121
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
012079
MO
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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