Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 014348 | MO |
NPI | 1174647333 |
---|---|
Provider Name | Dr. Bruce C. Cummings |
First Address | Kansas City, MO 64116-1515 |
Second Address | Kansas City, MO 64116-1515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 08/07/2007 |