# BETH BRUENING PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bruening Eye Specialists
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053446443
- **Authorized official:** TERRI SMITH (BILLING MANAGER)
- **Authorized official phone:** (605) 217-4500

## Contact information

- **Practice address:** 101 TOWER ROAD, SUITE 300, DAKOTA DUNES, SD 57049
- **Practice address phone:** (605) 217-4500
- **Practice address fax:** (605) 217-4503
- **Mailing address:** PO BOX 3566, SIOUX CITY, IA 51102-3566
- **Mailing address phone:** (605) 217-4500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 650 | SD | — |
| 174400000X | Specialist | 28135 | IA | — |
| 207W00000X | Ophthalmology Physician | 3577 | SD | Yes |

## Other

- **Enumeration date:** 02/23/2007
- **Last updated:** 08/04/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10025498700 | — | NE |
| 05 | — | 10025636300 | — | NE |
| 05 | — | 2072876 | — | IA |
| 01 | — | 28135 | IA LIC | IA |
| 01 | — | 3577 | SD LIC | SD |
| 05 | — | 7760323 | — | SD |