Most Relevant Information
Provider Data
| NPI Number: | 1003221748 |
| Provider Name: | BRYAN DAVID BRAASCH D.D.S. |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 12012182A |
Most Important Dates
| Enumeration Date: | 06/20/2014 |
| Last Updated: | 06/20/2014 |
Provider Practice Location
6821 WOODCREST DR
FORT WAYNE
IN
468155570
Practice Location Phone/Fax
| Phone: | 2604174981 |
| Fax: |
Provider Mailing Location
6821 WOODCREST DR
FORT WAYNE
IN
468155570
Provider Mailing Phone/Fax
| Phone: | 2604174981 |
| Fax: |