Individual
DR. BRUCE TERRY THARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4701 LOMAS BLVD NE, ALBUQUERQUE, NM 87110-6233
(505) 232-2273
(505) 255-2990
Mailing address
4701 LOMAS BLVD NE, ALBUQUERQUE, NM 87110-6233
(505) 232-2273
(505) 255-2990
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD3710
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273267056
—
NM
Enumeration date
07/06/2012
Last updated
07/06/2012
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