| Dr Paul A Bruggeman Dds Pc | |
|
17 S Virginia Crystal Lake IL 60014 | |
| (815) 455-3123 | |
| (815) 455-3139 |
| Full Name | Dr Paul A Bruggeman Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 17 S Virginia, Crystal Lake, Illinois |
| Authorized Official Name and Position | Paul A Bruggeman (OWNER) |
| Authorized Official Contact | 8154553123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Paul A Bruggeman Dds Pc 17 S Virginia Crystal Lake IL 60014 Ph: (815) 455-3123 | Dr Paul A Bruggeman Dds Pc 17 S Virginia Crystal Lake IL 60014 Ph: (815) 455-3123 |
| NPI Number | 1861565871 |
|---|---|
| Provider Enumeration Date | 11/16/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861565871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 19A14532 (Illinois) | Primary |
| 122300000X | Dentist | (Illinois) | Secondary |
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