Provider Demographics
NPI:1912023995
Name:BRUGLER, ROBERT BAXTER (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BAXTER
Last Name:BRUGLER
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 1:403 S. ALLEN ST
Mailing Address - Street 2:SUITE 209-A
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801
Mailing Address - Country:US
Mailing Address - Phone:814-231-7700
Mailing Address - Fax:814-231-7778
Practice Address - Street 1:403 S ALLEN ST
Practice Address - Street 2:SUITE 209-A
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-5252
Practice Address - Country:US
Practice Address - Phone:814-231-7700
Practice Address - Fax:814-231-7778
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025741L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice