Provider Demographics
NPI:1679672109
Name:BRUMFIELD, MOLLY KATHLEEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:KATHLEEN
Last Name:BRUMFIELD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:KATHLEEN
Other - Last Name:RIESTENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:10529 ADVENTURE LANE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242
Mailing Address - Country:US
Mailing Address - Phone:513-830-7746
Mailing Address - Fax:
Practice Address - Street 1:910 LOVELAND MADEIRA RD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-2795
Practice Address - Country:US
Practice Address - Phone:513-683-4040
Practice Address - Fax:513-697-2312
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH21202122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist