Dr. Bruce Edison Bentley Jr., D.D.S.
Dentist, Orthodontics and Dentofacial Orthopedics in Georgetown, TX. Individual provider (NPI-1).
NPI number1740339902
StatusActive
Last updated in NPPESJun 23, 2023
Details
- NPI
- 1740339902
- Entity type
- Individual (NPI-1)
- Name
- Dr. Bruce Edison Bentley Jr.
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 9, 2007
- Certification date
- Jun 23, 2023
- Last updated
- Jun 23, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | 30666 | TX | Yes |
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | 0401006597 | VA |
Practice location
1229 Leander RdGeorgetown, TX 78628-8707
Phone 434-841-4251 · Fax 512-688-5073
Mailing address
1229 Leander RdGeorgetown, TX 78628-8707
Phone 512-872-4200 · Fax 512-688-5073
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