Provider Demographics
NPI:1750583985
Name:FATTORE-BRUNO, LADEANE KATHERINE (DDS)
Entity type:Individual
Prefix:DR
First Name:LADEANE
Middle Name:KATHERINE
Last Name:FATTORE-BRUNO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LADEANE
Other - Middle Name:KATHERINE
Other - Last Name:FATTORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3041 E. FLAMINGO ROAD
Mailing Address - Street 2:SUITE C & D
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121
Mailing Address - Country:US
Mailing Address - Phone:702-309-9001
Mailing Address - Fax:702-309-9016
Practice Address - Street 1:3041 E. FLAMINGO ROAD
Practice Address - Street 2:SUITE C & D
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121
Practice Address - Country:US
Practice Address - Phone:702-309-9001
Practice Address - Fax:702-309-9016
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV42871223G0001X
AZD077761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice