Provider Demographics
NPI:1306963483
Name:DINNER, BRUCE J (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:J
Last Name:DINNER
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:PO BOX 524
Mailing Address - Street 2:
Mailing Address - City:FRANCONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03580-0524
Mailing Address - Country:US
Mailing Address - Phone:603-823-5537
Mailing Address - Fax:
Practice Address - Street 1:61 INDIAN PIPE ROAD
Practice Address - Street 2:
Practice Address - City:FRANCONIA
Practice Address - State:NH
Practice Address - Zip Code:03580-0524
Practice Address - Country:US
Practice Address - Phone:603-823-5537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH34841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice