Provider Demographics
NPI:1316789092
Name:BRUCE, ASHLEIGH LAUREN (DDS)
Entity type:Individual
Prefix:DR
First Name:ASHLEIGH
Middle Name:LAUREN
Last Name:BRUCE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7019 DOREEN ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-8436
Mailing Address - Country:US
Mailing Address - Phone:813-992-2138
Mailing Address - Fax:
Practice Address - Street 1:7019 DOREEN ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-8436
Practice Address - Country:US
Practice Address - Phone:813-992-2138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN290701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty