Provider Demographics
NPI:1386260081
Name:BRUNE, BRIAN (DMD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:BRUNE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4586 FIR DR
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-8570
Mailing Address - Country:US
Mailing Address - Phone:484-560-8270
Mailing Address - Fax:
Practice Address - Street 1:801 OLD YORK RD STE 403
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-1625
Practice Address - Country:US
Practice Address - Phone:215-277-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS042741122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist