Individual
BRUCE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
1107 SUMMITVIEW AVE, YAKIMA, WA 98902-3024
(509) 248-5181
(509) 575-7967
Mailing address
1107 SUMMITVIEW AVE, YAKIMA, WA 98902-3024
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DE00004817
WA
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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