Provider Demographics
NPI:1639918634
Name:BRUNO-PIVERGER, MELISSA (DDS)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BRUNO-PIVERGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3807 RHODE ISLAND AVE APT 317
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20722-1474
Mailing Address - Country:US
Mailing Address - Phone:954-687-2847
Mailing Address - Fax:
Practice Address - Street 1:600 W ST NW # 2005
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20059-1022
Practice Address - Country:US
Practice Address - Phone:202-806-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program