Provider Demographics
NPI:1619534138
Name:BRUGGER, VICTORIA LEIGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:LEIGH
Last Name:BRUGGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:LEIGH
Other - Last Name:SCHULTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:973 SKYLINE DR SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-1220
Mailing Address - Country:US
Mailing Address - Phone:507-424-1040
Mailing Address - Fax:
Practice Address - Street 1:973 SKYLINE DR SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-1220
Practice Address - Country:US
Practice Address - Phone:507-424-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND14167122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist