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Individual

DR. BETH BRUNNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD, MD, PLLC

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
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
054553
NY

Other

Enumeration date
06/26/2008
Last updated
04/24/2012
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