Provider Demographics
NPI:1568555696
Name:BRAM, SCOTT M (DMD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:M
Last Name:BRAM
Suffix:
Gender:M
Credentials:DMD
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Mailing Address - Street 1:1150 BERKSHIRE BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1208
Mailing Address - Country:US
Mailing Address - Phone:610-376-1536
Mailing Address - Fax:610-376-4241
Practice Address - Street 1:1150 BERKSHIRE BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1208
Practice Address - Country:US
Practice Address - Phone:610-376-1536
Practice Address - Fax:610-376-4241
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PADS025172L1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics