Organization
DANIEL B BRUIN DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL BRADLEY BRUIN BRUIN (OWNER)
(941) 468-5193
Entity
Organization
Contact information
Practice address
1811 MARTIN SPRINGS DR STE A, ROLLA, MO 65401-2978
(941) 468-5193
Mailing address
1811 MARTIN SPRINGS DR STE A, ROLLA, MO 65401-2978
(941) 468-5193
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
04/22/2026
Last updated
04/22/2026
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