Provider Demographics
NPI:1568843878
Name:BRUINS, WHITNEY VIOLET (DDS)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:VIOLET
Last Name:BRUINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 KELLY DR
Mailing Address - Street 2:
Mailing Address - City:WASHBURN
Mailing Address - State:ND
Mailing Address - Zip Code:58577-4111
Mailing Address - Country:US
Mailing Address - Phone:701-320-4259
Mailing Address - Fax:
Practice Address - Street 1:416 KUNDERT ST
Practice Address - Street 2:
Practice Address - City:TURTLE LAKE
Practice Address - State:ND
Practice Address - Zip Code:58575-4205
Practice Address - Country:US
Practice Address - Phone:701-448-9111
Practice Address - Fax:701-448-9224
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND22511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice