# BLUEBONNET DENTAL CARE @ CORDOBA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093969214
- **Authorized official:** ANDRE BRUNI DDS (OWNER)
- **Authorized official phone:** (337) 456-5573

## Contact information

- **Practice address:** 4906 AMBASSADOR CAFFERY PKWY, BUILDING I, LAFAYETTE, LA 70508-6962
- **Practice address phone:** (337) 456-5573
- **Mailing address:** 4451 BLUEBONNET BLVD, SUITE A, BATON ROUGE, LA 70809-9646
- **Mailing address phone:** (225) 767-2273

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5315 | LA | Yes |

## Other

- **Enumeration date:** 11/14/2008
- **Last updated:** 11/14/2008