Provider Demographics
NPI:1396841078
Name:STOCKINGER, BRUNO R (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUNO
Middle Name:R
Last Name:STOCKINGER
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 1:80 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-3553
Mailing Address - Country:US
Mailing Address - Phone:201-487-7200
Mailing Address - Fax:
Practice Address - Street 1:80 LINDEN ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3553
Practice Address - Country:US
Practice Address - Phone:201-487-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01903300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist