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Individual

DR. PHILLIP B BRUNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
400 SARALAND BLVD N, SUITE A, SARALAND, AL 36571-2152
(251) 675-5861
(251) 675-5105
Mailing address
400 SARALAND BLVD N, SUITE A, SARALAND, AL 36571-2152
(251) 675-5861
(251) 675-5105

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3573CS
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
510 90863
BLUE CROSS BLUE SHIELD OF
AL
01
591870
UNITED CONCORDIA INSURANC
AL
Enumeration date
04/04/2007
Last updated
07/07/2010
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