Individual
DR. DANIEL PAUL BRUNNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., D.D.S.
Contact information
Practice address
3535 ROSWELL RD, SUITE 27, MARIETTA, GA 30062-8826
(770) 321-0257
(770) 321-0346
Mailing address
3535 ROSWELL RD, SUITE 27, MARIETTA, GA 30062-8826
(770) 321-0257
(770) 321-0346
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN013859
GA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
053375
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402170337B
—
GA
Enumeration date
06/18/2010
Last updated
07/22/2019
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