| Doctor Name: | DANTE DE LOS SANTOS BRUNO |
| NPI Number: | 1700886298 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 53781 |
| Business Practice Address: | 1020 Bill Tuck Hwy Ste 900 South Boston, VA - 245927136 |
| Business Phone Number: | 4845757555 |
| Business Fax Number: | 4845755556 |
| Mailing Address: | 1020 Bill Tuck Hwy, Ste 900 SOUTH BOSTON |
| State: | VA |
| Postal Code: | 245927136 |
| Phone Number: | 4845757555 |
| Fax Number: | 4845755556 |
| NPI Enumeration Date: | 07/26/2005 |
| NPI Last Update Date: | 07/07/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 53781 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |