Individual
DR. BRUCE IVAN BAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DENTIST
Contact information
Practice address
386 CENTRAL AVE., JERSEY CITY, NJ 07307
(201) 659-5030
Mailing address
2 DEMAREST CT, ENGLEWOOD CLIFFS, NJ 07632-1904
(201) 567-4999
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI00877100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22DI00877100
DENTIST
NJ
Enumeration date
03/28/2007
Last updated
07/08/2007
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