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DANIEL THOMAS BRAUNECK DMD

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1700174216

Individual Registrant:
 DANIEL THOMAS BRAUNECK DMD
Gender: M
Sole Proprietor

Location and contact information for practice:
120 S HIGHWAY 19  PALATKA, FL 32177-3935 US
Tel: 386-328-9206  Fax: --

Contact information for business:
120 S HIGHWAY 19  PALATKA, FL 32177-3935 US
Tel: 386-328-9206  Fax: --

Registration Information:
NPI: 1700174216
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
FLDN 19423

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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