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General NPI Number Information
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NPI Number | 1386260081
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Entity Type | Individual
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Provider Name | BRIAN BRUNE DMD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2020
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Last Update Date | 06/18/2020
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Provider Practice Location Address
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Address Line | 801 OLD YORK RD STE 403
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City | JENKINTOWN
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State | PA
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Zip | 19046-1625
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Country | US
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Telephone | 215-277-7880
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Fax |
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Provider Business Mailing Address
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Address Line | 4586 FIR DR
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City | NAZARETH
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State | PA
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Zip | 18064-8570
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Country | US
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Telephone | 484-560-8270
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS042741
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License Number State | PA
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