Brunnworth, Tanner
Brunnworth, Tanner is an sole proprietor health care provider with primary practice located at 101 4Th Ave Ste D , Crestview FL 32539-2401. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Brunnworth, Tanner can be contacted via phone (850) 683-3544.Contact Information
Primary practice address
101 4Th Ave Ste D
Crestview FL 32539-2401
Phone: (850) 683-3544
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DN24128 | Florida |
Profile Details
| NPI number | 1508422197 |
|---|---|
| LBN Legal business name | Brunnworth, Tanner |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 19th, 2019 |
| Last updated | Aug 6th, 2023 - about 2 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.
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