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General NPI Number Information
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NPI Number | 1639318215
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Entity Type | Individual
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Provider Name | BRUNA BURGENER D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 02/05/2009
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Last Update Date | 06/29/2009
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Provider Practice Location Address
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Address Line | 522 CHESTNUT ST
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City | HINSDALE
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State | IL
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Zip | 60521-3171
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Country | US
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Telephone | 630-655-3636
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Fax |
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Provider Business Mailing Address
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Address Line | 521 W SUPERIOR ST APT 124
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City | CHICAGO
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State | IL
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Zip | 60654-3410
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Country | US
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Telephone | 646-256-1223
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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 | 019.027271
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License Number State | IL
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