Provider Demographics
NPI:1174822175
Name:BRUMFIELD & WEISBROT DENTISTRY, LLC
Entity Type:Organization
Organization Name:BRUMFIELD & WEISBROT DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUMFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-683-4040
Mailing Address - Street 1:910 LOVELAND MADEIRA RD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-2795
Mailing Address - Country:US
Mailing Address - Phone:513-683-4040
Mailing Address - Fax:513-697-2312
Practice Address - Street 1:910 LOVELAND MADEIRA RD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-2795
Practice Address - Country:US
Practice Address - Phone:513-683-4040
Practice Address - Fax:513-697-2312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0021202261QD0000X
OH0022011261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental