Healthcare Provider Details

I. General information

NPI: 1740741073
Provider Name (Legal Business Name): BRACES PLUS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2019
Last Update Date: 09/04/2020
Certification Date: 09/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1916 NINTH ST
ST THOMAS VI
00802-2640
US

IV. Provider business mailing address

1916 NINTH ST
ST THOMAS VI
00802-2640
US

V. Phone/Fax

Practice location:
  • Phone: 340-776-0030
  • Fax: 340-774-9760
Mailing address:
  • Phone: 340-776-0030
  • Fax: 340-774-9760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TREVOR A. C CONNOR
Title or Position: DENTIST
Credential: DDS
Phone: 340-776-0030