Individual
DR. JESSICA DOMINIQUE BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
29 BOKUM RD, CHESTER, CT 06412-1339
(860) 559-9146
Mailing address
29 BOKUM RD, CHESTER, CT 06412-1339
(860) 559-9146
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2.011701
CT
1223P0221X
Pediatric Dentistry
11701
CT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
11701
CT
Other
Enumeration date
07/08/2014
Last updated
08/26/2022
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