Provider Demographics
NPI:1851383376
Name:BRAUNSCHWEIGER, ALLEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:BRAUNSCHWEIGER
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 1:394 WILLIS AVE
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2329
Mailing Address - Country:US
Mailing Address - Phone:516-484-4730
Mailing Address - Fax:
Practice Address - Street 1:394 WILLIS AVE
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2329
Practice Address - Country:US
Practice Address - Phone:516-484-4730
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYD024840122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00304958Medicaid