MR. Tanner Brunnworth, DMD

NPI #1508422197 in Crestview, Florida

Provider Information

NPI Number: 1508422197
Entity Type: Individual
Name: MR. Tanner Brunnworth, DMD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: May 19, 2019
Last Updated: Aug 6, 2023

Practice Location

Address: 101 4TH AVE STE D
City: Crestview
State: Florida
ZIP Code: 32539-2401
Phone: (850) 683-3544

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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