Provider Demographics
NPI:1275618555
Name:KAPLAN, BRAD R (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:R
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 GOVERNOR ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3062
Mailing Address - Country:US
Mailing Address - Phone:401-861-5100
Mailing Address - Fax:401-861-1035
Practice Address - Street 1:149 GOVERNOR ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3062
Practice Address - Country:US
Practice Address - Phone:401-861-5100
Practice Address - Fax:401-861-1035
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI21991223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology