Provider Demographics
NPI:1669565966
Name:BRUCHMILLER, CHARLES LINWOOD (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:LINWOOD
Last Name:BRUCHMILLER
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 1:7400 LOUIS PASTEUR
Mailing Address - Street 2:STE 201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4542
Mailing Address - Country:US
Mailing Address - Phone:210-616-0745
Mailing Address - Fax:210-615-7776
Practice Address - Street 1:7400 LOUIS PASTEUR
Practice Address - Street 2:STE 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4542
Practice Address - Country:US
Practice Address - Phone:210-616-0745
Practice Address - Fax:210-615-7776
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX06324122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist