Mathiason, Bruce James

Mathiason, Bruce James is an individual health care provider with primary practice located at 400 7Th St , Walnut Grove MN 56180-9203. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mathiason, Bruce James can be contacted via phone (507) 859-2179.

Contact Information

Primary practice address
400 7Th St Walnut Grove MN 56180-9203
Phone: (507) 859-2179
Fax: (507) 859-2178
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D8569 Minnesota

Profile Details

NPI number 1366405722
LBN Legal business name Mathiason, Bruce James
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366405722 NPPES
Minnesota Other 2420L8000 MEDICALASSISTANCE

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