Provider Demographics
NPI:1730202060
Name:BRUNK, WILLIAM B (DDS)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:B
Last Name:BRUNK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 FALLS OF NEUSE RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3354
Mailing Address - Country:US
Mailing Address - Phone:919-676-0541
Mailing Address - Fax:919-676-0953
Practice Address - Street 1:7700 FALLS OF NEUSE RD
Practice Address - Street 2:SUITE 190
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3354
Practice Address - Country:US
Practice Address - Phone:919-676-0541
Practice Address - Fax:919-676-0953
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics