Organization
BLUEBONNET DENTAL CARE HATTIESBURG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRE BRUNI DDS (OWNER)
(225) 767-2273
Entity
Organization
Contact information
Practice address
6668 HWY 98 WEST STE G, HATTIESBURG, MS 39402
(225) 767-2273
Mailing address
4451 BLUEBONNET BLVD STE F, BATON ROUGE, LA 70809
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/19/2013
Last updated
07/15/2013
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