Provider Demographics
NPI:1124236070
Name:ALTSCHULER, BRUCE R (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:R
Last Name:ALTSCHULER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7308 SILENT BIRD CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1247
Mailing Address - Country:US
Mailing Address - Phone:410-309-6085
Mailing Address - Fax:410-309-6085
Practice Address - Street 1:7308 SILENT BIRD CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1247
Practice Address - Country:US
Practice Address - Phone:410-309-6085
Practice Address - Fax:410-309-6085
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6104122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist