Provider Demographics
NPI:1558473934
Name:BRAFMAN, KEVIN H (DDS)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:H
Last Name:BRAFMAN
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 1:31381 DOGWOOD ACRES RD
Mailing Address - Street 2:UNIT 2
Mailing Address - City:DAGSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19939
Mailing Address - Country:US
Mailing Address - Phone:302-732-3852
Mailing Address - Fax:302-732-3855
Practice Address - Street 1:31381 DOGWOOD ACRES RD
Practice Address - Street 2:UNIT 2
Practice Address - City:DAGSBORO
Practice Address - State:DE
Practice Address - Zip Code:19939
Practice Address - Country:US
Practice Address - Phone:302-732-3852
Practice Address - Fax:302-732-3855
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG11251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001026908Medicaid