Healthcare Provider Details

I. General information

NPI: 1013833896
Provider Name (Legal Business Name): BRASELTON ENDODONTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 FRIENDSHIP RD STE 115
BRASELTON GA
30517-5624
US

IV. Provider business mailing address

1235 FRIENDSHIP RD STE 115
BRASELTON GA
30517-5624
US

V. Phone/Fax

Practice location:
  • Phone: 586-707-7129
  • Fax:
Mailing address:
  • Phone: 586-707-7129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. JULIE BRANN
Title or Position: OWNER
Credential: DDS
Phone: 586-707-7129