Provider Demographics
NPI:1922274083
Name:BRUENS, ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:BRUENS
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 1:806 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4514
Mailing Address - Country:US
Mailing Address - Phone:516-352-7020
Mailing Address - Fax:516-352-4474
Practice Address - Street 1:806 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-4514
Practice Address - Country:US
Practice Address - Phone:516-352-7020
Practice Address - Fax:516-352-4474
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038645122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist