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Individual

MR. BRUCE E SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BC-HIS

Contact information

Practice address
99 CAMP MOWEEN RD, LEBANON, CT 06249-2704
(860) 859-0824
(869) 859-0824
Mailing address
99 CAMP MOWEEN RD, LEBANON, CT 06249-2704
(860) 859-0824
(869) 859-0824

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
000378
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00424577
CT
01
12DME0884CT01
ANTHEM BC/BS
CT
Enumeration date
08/31/2006
Last updated
07/08/2007
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