Provider Demographics
NPI:1154551299
Name:TAEME, BRUK E (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUK
Middle Name:E
Last Name:TAEME
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 K ST NE APT 101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3648
Mailing Address - Country:US
Mailing Address - Phone:202-546-0690
Mailing Address - Fax:202-782-3796
Practice Address - Street 1:701 K ST NE APT 101
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3648
Practice Address - Country:US
Practice Address - Phone:202-546-0690
Practice Address - Fax:202-782-3796
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037927122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist