Individual
DR. CHARLES WILLIAM BRUCHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1077 HELMO AVE N STE 130, OAKDALE, MN 55128-5710
(651) 238-6795
Mailing address
1077 HELMO AVE N STE 130, OAKDALE, MN 55128-5710
(651) 238-6795
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
00203475
CO
1223G0001X
General Practice Dentistry
00203475
CO
1223G0001X
General Practice Dentistry
Primary
D14692
MN
Other
Enumeration date
03/28/2018
Last updated
03/10/2022
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