Michael Joseph Bruns, DDS

Individual provider Active NPI General Practice Dentistry · Coldwater, OH

NPI 1922196898 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1922196898
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
17579 (OH)
Practice address
750 W Main St
Coldwater, OH 45828-0068
Phone
(419) 678-4806
Fax
(419) 678-0077
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
17579OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Coldwater Dental Inc General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 17579 OH Yes

Addresses

Primary practice location

750 W Main St
Coldwater, OH 45828-0068

Mailing address

750 W Main St
PO Box 68
Coldwater, OH 45828-0068
Phone (419) 678-4806

Other identifiers

IdentifierTypeStateIssuer
0820562MedicaidOH

Other providers in Coldwater, OH

All providers in Coldwater, OH · General Practice Dentistry in Ohio

Sources for this page

Verify at the official NPI Registry.