Individual
BRUNO AZEVEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
501 S PRESTON ST RM 149F, LOUISVILLE, KY 40202-1701
(502) 852-1241
Mailing address
501 S PRESTON ST RM 149F, LOUISVILLE, KY 40202-1701
(502) 852-1241
Taxonomy
Speciality
Code
Description
License number
State
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
9538
KY
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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