MEDICARE: DR. ROBERT ANTHONY BRUGNONE 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
1	1223G0001X	General Practice Dentistry	101573	CA

General Provider Information

NPI Number	:	1245752872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT ANTHONY BRUGNONE DDS

Provider Business Mailing Address
First Line	:	1209 REBECCA LN UNIT E
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93105-4662
Country	:	US
Telephone Number	:	805-294-8327
Fax Number	:

Provider Business Practice Location Address
First Line	:	536 E ARRELLAGA ST STE 101
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93103-2262
Country	:	US
Telephone Number	:	805-884-1874
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2017
Last Update Date	:	03/17/2018

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