Individual
DR. DANIEL BRADLEY BRUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD MS
Contact information
Practice address
6958 NEBRASKA AVE, FORT LEONARD WOOD, MO 65473-1618
(573) 596-3038
Mailing address
6958 NEBRASKA AVE, FORT LEONARD WOOD, MO 65473-1618
(573) 596-3606
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN20166
FL
1223P0300X
Periodontics
Primary
DN20166
FL
Other
Enumeration date
06/21/2013
Last updated
05/13/2025
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