# BRUICK DENTISTRY PC

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

## Provider details

- **NPI number:** 1740448232
- **Authorized official:** DR. DWANE R BRUICK DDS (OWNER)
- **Authorized official phone:** (260) 485-0583

## Contact information

- **Practice address:** 6405 GEORGETOWN NORTH BLVD, FORT WAYNE, IN 46815-7007
- **Practice address phone:** (260) 485-0583
- **Practice address fax:** (260) 485-8029
- **Mailing address:** 6405 GEORGETOWN NORTH BLVD, FORT WAYNE, IN 46815-7007
- **Mailing address phone:** (260) 485-0583
- **Mailing address fax:** (260) 485-8029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 8370 | IN | Yes |

## Other

- **Enumeration date:** 05/30/2008
- **Last updated:** 05/30/2008