Provider Demographics
NPI:1073692430
Name:BRUNO, JULIA MARIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:MARIA
Last Name:BRUNO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 JESSE HILL JR. DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3030
Mailing Address - Country:US
Mailing Address - Phone:404-730-1471
Mailing Address - Fax:404-730-1475
Practice Address - Street 1:99 JESSE HILL JR. DRIVE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3030
Practice Address - Country:US
Practice Address - Phone:404-730-1471
Practice Address - Fax:404-730-1475
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2236122300000X
GADPH00005122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist