Provider Demographics
NPI:1396765962
Name:BRUHIN, MICHAEL JOSEPH (DDS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:BRUHIN
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 1:1226 W ASH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-4656
Mailing Address - Country:US
Mailing Address - Phone:970-686-7858
Mailing Address - Fax:970-686-5623
Practice Address - Street 1:1226 W ASH ST
Practice Address - Street 2:SUITE A
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-4656
Practice Address - Country:US
Practice Address - Phone:970-686-7858
Practice Address - Fax:970-686-5623
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO007381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice