Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARK A BRUNNER, DDS
ActiveDR. MARK A BRUNNER, DDS is a Periodontology healthcare provider located in JENISON, Michigan. NPI 1891714135 is currently active in the NPPES registry. Verify at CMS.
Periodontology · JENISON, MI
Registration Details
- NPI Number
- 1891714135
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 18, 2006 (20.09809810022 yrs)
- Last Updated
- Mar 14, 2025
- License
-
12499 (GA)
Practice Information
- Address
-
2064 BALDWIN ST STE AJENISON, MI, 494288773Browse MI providers · Browse ZIP 49428
- Phone
- 6162643815
- Fax
- 4043529381
- Primary Specialty
-
Periodontology
1223P0300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.