Provider Demographics
NPI:1063487965
Name:BRACHVOGEL, WILLIAM ABEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ABEL
Last Name:BRACHVOGEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 FOLSOM ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5712
Mailing Address - Country:US
Mailing Address - Phone:303-443-1146
Mailing Address - Fax:303-442-7572
Practice Address - Street 1:1840 FOLSOM ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5712
Practice Address - Country:US
Practice Address - Phone:303-443-1146
Practice Address - Fax:303-442-7572
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO68661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice