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Individual

DR. VAUGHN ELLIOT BRUMMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1400 PRIDE AVENUE, MADISONVILLE, KY 42431-9108
(270) 821-7386
(270) 821-7401
Mailing address
1400 PRIDE AVENUE, MADISONVILLE, KY 42431-9108
(270) 821-7386
(270) 821-7401

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
12010912A
IN
1223P0221X
Pediatric Dentistry
Primary
7957
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
45002789
KY
05
60002219
KY
Enumeration date
11/24/2006
Last updated
02/24/2014
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