Provider Demographics
NPI:1083697577
Name:BRAFF, MICHAEL H (DDS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:BRAFF
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 1:921 NOTT ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-2318
Mailing Address - Country:US
Mailing Address - Phone:518-370-5506
Mailing Address - Fax:518-393-8713
Practice Address - Street 1:921 NOTT ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2318
Practice Address - Country:US
Practice Address - Phone:518-370-5506
Practice Address - Fax:518-393-8713
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0268371223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00358690Medicaid