DR. Bruce Edward Mathes, DDS

NPI #1992893614 in Peoria, Illinois

Provider Information

NPI Number: 1992893614
Entity Type: Individual
Name: DR. Bruce Edward Mathes, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Oct 10, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 121 E LAKE AVE
Address 2: STE G
City: Peoria
State: Illinois
ZIP Code: 61614-6182
Phone: (309) 685-2112

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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