Individual
BRUCE ARTHUR MERRIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
250 PATCHOGUE YAPHANK RD, SUITE 9, EAST PATCHOGUE, NY 11772-4800
(631) 475-3400
(631) 475-3465
Mailing address
250 PATCHOGUE YAPHANK RD, SUITE 9, EAST PATCHOGUE, NY 11772-4800
(631) 475-3400
(631) 475-3465
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
028780-1
NY
Other
Enumeration date
12/11/2007
Last updated
12/11/2007
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