Provider Demographics
NPI:1255758983
Name:BRACES R US
Entity type:Organization
Organization Name:BRACES R US
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MDS
Authorized Official - Phone:480-668-8200
Mailing Address - Street 1:1702 S VAL VISTA DR # 101
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-7304
Mailing Address - Country:US
Mailing Address - Phone:480-668-8200
Mailing Address - Fax:480-668-8202
Practice Address - Street 1:1702 S VAL VISTA DR # 101
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-7304
Practice Address - Country:US
Practice Address - Phone:480-668-8200
Practice Address - Fax:480-668-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0081761223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1841393212OtherNPI