Provider Demographics
NPI:1124683073
Name:BRUNET, VERONICA L (DDS)
Entity type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:L
Last Name:BRUNET
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 W SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:OH
Mailing Address - Zip Code:45828-1623
Mailing Address - Country:US
Mailing Address - Phone:419-678-3170
Mailing Address - Fax:
Practice Address - Street 1:702 W SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:OH
Practice Address - Zip Code:45828-1623
Practice Address - Country:US
Practice Address - Phone:419-678-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0257561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice