Organization
BRUCE R TRIPP JR DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE RAY TRIPP JR. DDS (OWNER)
(252) 752-7880
Entity
Organization
Contact information
Practice address
5076 US 264 E, GREENVILLE, NC 27834-5804
(252) 752-7880
(252) 752-9602
Mailing address
5076 US 264 E, GREENVILLE, NC 27834-5804
(252) 752-7880
(252) 752-9602
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5112
NC
124Q00000X
Dental Hygienist
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5919749
—
NC
Enumeration date
01/31/2012
Last updated
08/09/2013
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