Provider Demographics
NPI:1619056074
Name:BRANSTETTER, ROBERT MURRAY JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MURRAY
Last Name:BRANSTETTER
Suffix:JR
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 1:6155 HARRY DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-2539
Mailing Address - Country:US
Mailing Address - Phone:225-924-4208
Mailing Address - Fax:225-924-4209
Practice Address - Street 1:6155 HARRY DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-2539
Practice Address - Country:US
Practice Address - Phone:225-924-4208
Practice Address - Fax:225-924-4209
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA21921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice