Bruggeman, Vern Barry
Bruggeman, Vern Barry is an sole proprietor health care provider with primary practice located at 333 So Woodruff Ave , Idaho Falls ID 83401. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Bruggeman, Vern Barry can be contacted via phone (208) 524-2036.Contact Information
Primary practice address
333 So Woodruff Ave
Idaho Falls ID 83401
Phone: (208) 524-2036
Fax: (208) 523-9004
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | D1471 | Idaho |
Profile Details
| NPI number | 1619010477 |
|---|---|
| LBN Legal business name | Bruggeman, Vern Barry |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 14th, 2007 |
| Last updated | Jun 11th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619010477 | NPPES |
| Idaho | MEDICAID | 001596200 |
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