Individual
DR. KRISTEN NICOLE BRUNNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1717 S CALHOUN ST, FORT WAYNE, IN 46802-5257
(260) 458-2641
Mailing address
1716 MADISON ST, DECATUR, IN 46733-1438
(260) 701-8866
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012716A
IN
Other
Enumeration date
05/26/2017
Last updated
12/04/2019
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