Individual
DR. BRUCE HENRY HMUROVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3099 CENTRAL AVE, LAKE STATION, IN 46405-2207
(219) 763-8112
(219) 764-3251
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
(219) 764-3251
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
44321
CA
1223G0001X
General Practice Dentistry
Primary
12011385A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IN
Enumeration date
01/17/2007
Last updated
02/08/2011
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