Beth Brunner, Dmd, PLLC
Clinic/Center, Dental in Lake Placid, NY. Organization (NPI-2).
NPI number1487930004
StatusActive
Last updated in NPPESApr 26, 2012
Details
- NPI
- 1487930004
- Entity type
- Organization (NPI-2)
- Legal business name
- Beth Brunner, Dmd, PLLC
- Organization subpart
- No
- Enumeration date
- Oct 27, 2011
- Last updated
- Apr 26, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 054553 | NY | Yes |
Other names
- Lake Placid Oral Surgery (Doing Business As)
Practice location
1936 Saranac AveSuite 101
Lake Placid, NY 12946-1114
Phone 518-837-5019 · Fax 518-837-5093
Mailing address
1936 Saranac AveSuite 101
Lake Placid, NY 12946-1114
Phone 518-837-5019 · Fax 518-837-5093
Authorized official
Beth Brunner
Owner
5188375019
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