Healthcare Provider Details

I. General information

NPI: 1558473934
Provider Name (Legal Business Name): KEVIN H BRAFMAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31381 DOGWOOD ACRES RD UNIT 2
DAGSBORO DE
19939
US

IV. Provider business mailing address

31381 DOGWOOD ACRES RD UNIT 2
DAGSBORO DE
19939
US

V. Phone/Fax

Practice location:
  • Phone: 302-732-3852
  • Fax: 302-732-3855
Mailing address:
  • Phone: 302-732-3852
  • Fax: 302-732-3855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberG1125
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: