Provider Demographics
NPI:1467837823
Name:BRAUER, ERIK (RDHAP)
Entity Type:Individual
Prefix:MR
First Name:ERIK
Middle Name:
Last Name:BRAUER
Suffix:
Gender:M
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5463 PASEO DEL LAGO E UNIT C
Mailing Address - Street 2:
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-7348
Mailing Address - Country:US
Mailing Address - Phone:949-813-0510
Mailing Address - Fax:949-607-5883
Practice Address - Street 1:5463 PASEO DEL LAGO E UNIT C
Practice Address - Street 2:
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-7348
Practice Address - Country:US
Practice Address - Phone:949-813-0510
Practice Address - Fax:949-607-5883
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA582124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist