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General NPI Number Information
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NPI Number | 1700081635
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Entity Type | Individual
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Provider Name | DEA L BRUEGGEMEYER D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8901 WISCONSIN AVE
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City | BETHESDA
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State | MD
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Zip | 20889-0001
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Country | US
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Telephone | 301-295-0145
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Fax |
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Provider Business Mailing Address
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Address Line | 10301 STRATHMORE HALL ST APT 414
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City | ROCKVILLE
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State | MD
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Zip | 20852-6688
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Country | US
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Telephone | 502-797-4792
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8505
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License Number State | KY
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