NPI 1720137029 · live from the CMS NPI Registry
Kathy Bruster
Dentist, Orthodontics and Dentofacial Orthopedics in Atlanta, GA. National Provider Identifier 1720137029, active.
NPI record
| NPI | 1720137029 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 1901 Phoenix Blvd, Atlanta, GA 30349 |
| Practice phone | 770-991-0913 |
| Mailing address | 912 Carriage Path Se, Smyrna, GA 30082 |
| Enumerated | January 9, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | 11406 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.