Provider Demographics
NPI:1609264357
Name:BRAUN, SUSAN SCHLUSSEL (DDS)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:SCHLUSSEL
Last Name:BRAUN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MEADOW PL
Mailing Address - Street 2:
Mailing Address - City:OLD GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06870-2114
Mailing Address - Country:US
Mailing Address - Phone:203-698-2500
Mailing Address - Fax:
Practice Address - Street 1:17 MEADOW PL
Practice Address - Street 2:
Practice Address - City:OLD GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06870-2114
Practice Address - Country:US
Practice Address - Phone:203-698-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006374122300000X
NY036205122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist