Provider Demographics
NPI:1326268020
Name:BRAUN, ERVIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERVIN
Middle Name:
Last Name:BRAUN
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 1:24 OLD KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4537
Mailing Address - Country:US
Mailing Address - Phone:203-655-1541
Mailing Address - Fax:203-655-9064
Practice Address - Street 1:24 OLD KINGS HWY S
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4537
Practice Address - Country:US
Practice Address - Phone:203-655-1541
Practice Address - Fax:203-655-9064
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT60201223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics