Bentley, Bruce Edison
Bentley, Bruce Edison is an sole proprietor health care provider with primary practice located at 1229 Leander Rd , Georgetown TX 78628-8707. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Bentley, Bruce Edison can be contacted via phone (434) 841-4251.Contact Information
Primary practice address
1229 Leander Rd
Georgetown TX 78628-8707
Phone: (434) 841-4251
Fax: (512) 688-5073
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 0401006597 | Virginia |
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 30666 | Texas |
Profile Details
| NPI number | 1740339902 |
|---|---|
| LBN Legal business name | Bentley, Bruce Edison |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 9th, 2007 |
| Last updated | Jun 23rd, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740339902 | NPPES |
| Virginia | MEDICAID | 13823 |
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