Individual
DR. SAMUEL PAUL BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(270) 412-8545
Mailing address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(270) 412-8545
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9639
SC
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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