Provider Demographics
NPI:1295827848
Name:BRUNELL, DAVID S (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:BRUNELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 YORBA PL
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3152
Mailing Address - Country:US
Mailing Address - Phone:714-524-0656
Mailing Address - Fax:714-524-0884
Practice Address - Street 1:1075 YORBA PL
Practice Address - Street 2:SUITE 210
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3152
Practice Address - Country:US
Practice Address - Phone:714-524-0656
Practice Address - Fax:714-524-0884
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA335531223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics