MEDICARE: DR. KEVIN F BRAUN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	CT5294	CT

General Provider Information

NPI Number	:	1902066921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN F BRAUN DDS

Provider Business Mailing Address
First Line	:	56 CHURCH HILL ROAD
Second Line	:
City	:	NEWTOWN
State	:	CT
Zip	:	06470
Country	:	US
Telephone Number	:	203-426-9692
Fax Number	:

Provider Business Practice Location Address
First Line	:	56 CHURCH HILL ROAD
Second Line	:
City	:	NEWTOWN
State	:	CT
Zip	:	06470
Country	:	US
Telephone Number	:	203-426-9692
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2008
Last Update Date	:	06/12/2008

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