Bruno, Candace Lauren

Bruno, Candace Lauren is an sole proprietor health care provider with primary practice located at 11410 Jollyville Rd 3102, Austin TX 78759-4097. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / Dentist is her primary health care specialty. Bruno, Candace Lauren can be contacted via phone (512) 372-8484.

Contact Information

Primary practice address
11410 Jollyville Rd 3102 Austin TX 78759-4097
Phone: (512) 372-8484
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 0025624 Texas
Dental Providers / General Practice 1223G0001X 0025624 Texas

Profile Details

NPI number 1609188259
LBN Legal business name Bruno, Candace Lauren
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 12th, 2010
Last updated Feb 13th, 2017 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1609188259 NPPES
Texas MEDICAID 2128852-01

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