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Organization

DR PAUL A BRUGGEMAN DDS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL A BRUGGEMAN DDS (OWNER)
(815) 455-3123
Entity
Organization

Contact information

Practice address
17 S VIRGINIA, CRYSTAL LAKE, IL 60014
(815) 455-3123
(815) 455-3139
Mailing address
17 S VIRGINIA, CRYSTAL LAKE, IL 60014
(815) 455-3123
(815) 455-3139

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19A14532
IL
122300000X
Dentist
IL

Other

Enumeration date
11/16/2006
Last updated
08/22/2020
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