Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 13223 | MA |
NPI | 1013138304 |
---|---|
Provider Name | Bruce M Field |
First Address | Auburn, MA 01501-2585 |
Second Address | Auburn, MA 01501-2585 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 08/07/2007 |