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NPI Code Detail

MEDICARE: DR. ANDRE H BRUNI DDS

MEDICARE: DR. ANDRE H BRUNI DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry5315LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1852927446OTHERGENERAL DENTIST
285-2927446OTHERLAGENERAL DENTIST

General Provider Information

NPI Number : 1639381890
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDRE H BRUNI DDS
Provider Business Mailing Address
First Line : 11001 HIGHLAND RD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-4306
Country : US
Telephone Number : 225-277-3311
Fax Number : 225-351-8859
Provider Business Practice Location Address
First Line : 7017 PERKINS RD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-4320
Country : US
Telephone Number : 225-277-3311
Fax Number : 225-351-8859
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 05/11/2022

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