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General NPI Number Information
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NPI Number | 1770304099
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Entity Type | Organization
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Legal Business Name | BRACHO DENTAL SOLUTIONS LLC
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Dates
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Enumeration Date | 10/19/2024
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Last Update Date | 10/19/2024
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Provider Practice Location Address
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Address Line | 925 HIGH POINT DR
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City | NAPLES
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State | FL
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Zip | 34103-3879
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Country | US
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Telephone | 239-262-1535
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Fax |
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Provider Business Mailing Address
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Address Line | 7081 LIVE OAK DR
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City | NAPLES
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State | FL
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Zip | 34114-8154
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Country | US
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Telephone | 240-401-0553
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | ROBERT BRACHO
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Credential | DDS
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Telephone | 240-401-0553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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