Provider Demographics
NPI:1841260981
Name:BRAYMAN, TATYANA (DDS)
Entity type:Individual
Prefix:DR
First Name:TATYANA
Middle Name:
Last Name:BRAYMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5758 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1826
Mailing Address - Country:US
Mailing Address - Phone:248-674-1500
Mailing Address - Fax:248-674-6408
Practice Address - Street 1:5758 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-1826
Practice Address - Country:US
Practice Address - Phone:248-674-1500
Practice Address - Fax:248-674-6408
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0179551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice