Provider Demographics
NPI:1194341842
Name:ZHANG, BRUCE (DMD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 ALCOA HIGHWAY
Mailing Address - Street 2:SUITE 335
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920
Mailing Address - Country:US
Mailing Address - Phone:865-305-9022
Mailing Address - Fax:865-305-9026
Practice Address - Street 1:1930 ALCOA HIGHWAY
Practice Address - Street 2:SUITE 335
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920
Practice Address - Country:US
Practice Address - Phone:865-305-9022
Practice Address - Fax:865-305-9026
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2024-03-21
Deactivation Date:2022-01-18
Deactivation Code:
Reactivation Date:2022-04-15
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program