Provider Demographics
NPI:1295176683
Name:BRAUD, CHRISTOPHER HENRY (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:HENRY
Last Name:BRAUD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 CHRISTIAN LN
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-1356
Mailing Address - Country:US
Mailing Address - Phone:985-640-0351
Mailing Address - Fax:
Practice Address - Street 1:480 OAK HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-8817
Practice Address - Country:US
Practice Address - Phone:985-649-9455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA64061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice