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General NPI Number Information
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NPI Number | 1922403047
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Entity Type | Organization
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Legal Business Name | BRUEGGEN DENTAL IMPLANT CENTER
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Dates
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Enumeration Date | 10/31/2014
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Last Update Date | 10/31/2014
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Provider Practice Location Address
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Address Line | 14626 BELLAIRE BLVD
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City | HOUSTON
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State | TX
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Zip | 77083-2506
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Country | US
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Telephone | 281-879-1786
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Fax | 281-879-8147
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Provider Business Mailing Address
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Address Line | 14626 BELLAIRE BLVD
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City | HOUSTON
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State | TX
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Zip | 77083-2506
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Country | US
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Telephone | 281-879-1786
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Fax | 281-879-8147
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Authorized Official
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Title or Position | OWNER
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Name | DR. HAROLD W BRUEGGEN
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Credential | DDS,FAGD,FICOI
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Telephone | 281-879-1786
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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 |
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License Number State |
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