Organization
BLUEBONNET DENTAL CARE @ CORDOBA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRE BRUNI DDS (OWNER)
(337) 456-5573
Entity
Organization
Contact information
Practice address
4906 AMBASSADOR CAFFERY PKWY, BUILDING I, LAFAYETTE, LA 70508-6962
(337) 456-5573
Mailing address
4451 BLUEBONNET BLVD, SUITE A, BATON ROUGE, LA 70809-9646
(225) 767-2273
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5315
LA
Other
Enumeration date
11/14/2008
Last updated
11/14/2008
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