Individual
KAITLYN BRUENING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
400 S TOWNLINE RD, WAUTOMA, WI 54982-6922
(920) 787-5514
(920) 787-4737
Mailing address
PO BOX 1440, WAUTOMA, WI 54982-1440
(920) 787-5514
(920) 787-4737
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1003166
WI
Other
Enumeration date
10/13/2021
Last updated
12/02/2021
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