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General NPI Number Information
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NPI Number | 1588684054
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Entity Type | Organization
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Legal Business Name | THOMAS F BRAUN, D. M. D., LLC
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 08/11/2010
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Provider Practice Location Address
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Address Line | 427 STILLSON RD STE 12
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City | FAIRFIELD
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State | CT
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Zip | 06824
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Country | US
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Telephone | 203-374-0512
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Fax |
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Provider Business Mailing Address
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Address Line | 427 STILLSON RD STE 12
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City | FAIRFIELD
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State | CT
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Zip | 06824
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Country | US
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Telephone | 203-374-0512
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS BRAUN
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Credential | D. M. D.
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Telephone | 203-374-0512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 5825
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License Number State | CT
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