DR. Jerry Kent Brunsoman, D.D.S., M.S.

NPI #1356342505 in Maplewood, Minnesota

Provider Information

NPI Number: 1356342505
Entity Type: Individual
Name: DR. Jerry Kent Brunsoman, D.D.S., M.S.
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Dentist - Oral and Maxillofacial Surgery
Credential: D.D.S., M.S.
Enumeration Date: Aug 9, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 1774 COPE AVE E
Address 2: SUITE 140
City: Maplewood
State: Minnesota
ZIP Code: 55109-2662
Phone: (651) 774-9611

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X	Primary

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