Maxwell, Bruce Craig
Maxwell, Bruce Craig is an sole proprietor health care provider with primary practice located at 747 W Broadway St , West Plains MO 65775-2368. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Maxwell, Bruce Craig can be contacted via phone (417) 256-2525.Contact Information
Primary practice address
747 W Broadway St
West Plains MO 65775-2368
Phone: (417) 256-2525
Fax: (417) 256-7546
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 2006000187 | Missouri |
Profile Details
| NPI number | 1184689069 |
|---|---|
| LBN Legal business name | Maxwell, Bruce Craig |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 20th, 2006 |
| Last updated | Sep 18th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184689069 | NPPES |
| Missouri | MEDICAID | 405408501 | |
| Missouri | MEDICAID | 407595800 |
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