Individual
BRUCE A BENNETT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 PHALEN BLVD, MAIL STOP 41104A, ST PAUL, MN 55101-5302
(651) 254-7980
(651) 254-7969
Mailing address
8100 34TH AVE S, 21110Q, BLOOMINGTON, MN 55425-1672
(952) 883-5790
(952) 883-5395
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
36874
MN
Other
Enumeration date
02/22/2006
Last updated
07/08/2007
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