Provider Demographics
NPI:1629121637
Name:BRAUNSTEIN, GREG (DMD)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:
Last Name:BRAUNSTEIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 SE OCEAN BLVD
Mailing Address - Street 2:SUITE B-110
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2471
Mailing Address - Country:US
Mailing Address - Phone:772-286-3000
Mailing Address - Fax:772-283-2211
Practice Address - Street 1:900 SE OCEAN BLVD
Practice Address - Street 2:SUITE B-110
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2471
Practice Address - Country:US
Practice Address - Phone:772-286-3000
Practice Address - Fax:772-283-2211
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL63011223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics