Provider Demographics
NPI:1710031778
Name:BRAUN & JARVIS FAMILY DENTISTRY, PS
Entity Type:Organization
Organization Name:BRAUN & JARVIS FAMILY DENTISTRY, PS
Other - Org Name:RODNEY D. BRAUN, DDS, PS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:HIPPA DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEDVED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-464-2391
Mailing Address - Street 1:775 E HOLLAND AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1257
Mailing Address - Country:US
Mailing Address - Phone:509-464-2391
Mailing Address - Fax:509-232-0555
Practice Address - Street 1:775 E HOLLAND AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1257
Practice Address - Country:US
Practice Address - Phone:509-464-2391
Practice Address - Fax:509-232-0555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty