Provider Demographics
NPI:1467602672
Name:KAREN BRUGGERS DDS MS PA
Entity Type:Organization
Organization Name:KAREN BRUGGERS DDS MS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BRUGGERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:919-858-8193
Mailing Address - Street 1:1400 CRESCENT GREEN
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518
Mailing Address - Country:US
Mailing Address - Phone:919-858-8193
Mailing Address - Fax:919-858-8198
Practice Address - Street 1:1400 CRESCENT GREEN
Practice Address - Street 2:SUITE 210
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518
Practice Address - Country:US
Practice Address - Phone:919-858-8193
Practice Address - Fax:919-858-8198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4167122300000X
NC56991223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty