Provider Demographics
NPI:1831363076
Name:BARBARA J. RUNNE, D.D.S.
Entity type:Organization
Organization Name:BARBARA J. RUNNE, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECEPTIONIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-522-3541
Mailing Address - Street 1:105 BRENNAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60146-0000
Mailing Address - Country:US
Mailing Address - Phone:815-522-3541
Mailing Address - Fax:815-522-2107
Practice Address - Street 1:105 BRENNAN DRIVE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:IL
Practice Address - Zip Code:60146
Practice Address - Country:US
Practice Address - Phone:815-522-3541
Practice Address - Fax:815-522-2107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty