Organization
BETH BRUENING PC
Active
Other names
Bruening Eye Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI SMITH (BILLING MANAGER)
(605) 217-4500
Entity
Organization
Contact information
Practice address
101 TOWER ROAD, SUITE 300, DAKOTA DUNES, SD 57049
(605) 217-4500
(605) 217-4503
Mailing address
PO BOX 3566, SIOUX CITY, IA 51102-3566
(605) 217-4500
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
650
SD
174400000X
Specialist
28135
IA
207W00000X
Ophthalmology Physician
Primary
3577
SD
Other
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
Enumeration date
02/23/2007
Last updated
08/04/2017
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