Organization
BETH BRUNNER, DMD, PLLC
Active
Other names
Lake Placid Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETH BRUNNER DMD, MD, PLLC (OWNER)
(518) 837-5019
Entity
Organization
Contact information
Practice address
1936 SARANAC AVE, SUITE 101, LAKE PLACID, NY 12946-1114
(518) 837-5019
(518) 837-5093
Mailing address
1936 SARANAC AVE, SUITE 101, LAKE PLACID, NY 12946-1114
(518) 837-5019
(518) 837-5093
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
054553
NY
Other
Enumeration date
10/27/2011
Last updated
04/26/2012
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