Individual
DR. PAUL A BRUGGEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
17 S VIRGINIA ROAD, CRYSTAL LAKE, IL 60014
(815) 455-3123
(815) 455-3139
Mailing address
17 S VIRGINIA ROAD, CRYSTAL LAKE, IL 60014
(815) 455-3123
(815) 455-3139
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19A14532
IL
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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