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Individual

DR. BRUCE ALLEN MOEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1100 31ST AVE SW, SUITE 2, MINOT, ND 58701-2007
(701) 837-0022
(701) 839-2005
Mailing address
1100 31ST AVE SW, SUITE 2, MINOT, ND 58701-2007
(701) 837-0022
(701) 839-2005

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
429
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60328
ND
Enumeration date
07/03/2006
Last updated
10/05/2007
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