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NPI Code Detail

MEDICARE: DR. LORNA MILLAR BRUNHOFER D.M.D.

MEDICARE: DR. LORNA MILLAR BRUNHOFER D.M.D.
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
1122300000XDentist3605AL

General Provider Information

NPI Number : 1255310777
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LORNA MILLAR BRUNHOFER D.M.D.
Provider Business Mailing Address
First Line : 3259 CATLIN AVE
Second Line :
City : QUANTICO
State : VA
Zip : 22134-5109
Country : US
Telephone Number : 703-784-2802
Fax Number :
Provider Business Practice Location Address
First Line : 3259 CATLIN AVE
Second Line :
City : QUANTICO
State : VA
Zip : 22134-5109
Country : US
Telephone Number : 703-784-2802
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2006
Last Update Date : 09/18/2008

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