Provider Demographics
NPI:1922403047
Name:BRUEGGEN DENTAL IMPLANT CENTER
Entity Type:Organization
Organization Name:BRUEGGEN DENTAL IMPLANT CENTER
Other - Org Name:H.W.BRUEGGEN,D.D.S.,INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:W
Authorized Official - Last Name:BRUEGGEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,FAGD,FICOI
Authorized Official - Phone:281-879-1786
Mailing Address - Street 1:14626 BELLAIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-2506
Mailing Address - Country:US
Mailing Address - Phone:281-879-1786
Mailing Address - Fax:281-879-8147
Practice Address - Street 1:14626 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-2506
Practice Address - Country:US
Practice Address - Phone:281-879-1786
Practice Address - Fax:281-879-8147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty