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General NPI Number Information
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NPI Number | 1144319245
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Entity Type | Individual
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Provider Name | THOMAS BRAUN DDS
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 1100 POQUONNOCK RD
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City | GROTON
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State | CT
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Zip | 06340-4209
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Country | US
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Telephone | 860-421-9936
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Fax |
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Provider Business Mailing Address
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Address Line | 201 HADDAM QUARTER RD
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City | DURHAM
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State | CT
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Zip | 06422-1622
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Country | US
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Telephone | 860-795-7997
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 17112
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7207
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License Number State | CT
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