Provider Demographics
NPI:1629186408
Name:KRATZ, BRAYDON H (DDS PA)
Entity Type:Individual
Prefix:
First Name:BRAYDON
Middle Name:H
Last Name:KRATZ
Suffix:
Gender:M
Credentials:DDS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23855 CINCO RANCH BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3172
Mailing Address - Country:US
Mailing Address - Phone:281-391-4422
Mailing Address - Fax:281-391-4424
Practice Address - Street 1:23855 CINCO RANCH BLVD STE 240
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3172
Practice Address - Country:US
Practice Address - Phone:281-391-4422
Practice Address - Fax:281-391-4424
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice