Provider Demographics
NPI:1174019186
Name:BRANDON M. BRAID DDS II LLC
Entity type:Organization
Organization Name:BRANDON M. BRAID DDS II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-289-2831
Mailing Address - Street 1:7230 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-1735
Mailing Address - Country:US
Mailing Address - Phone:303-289-2831
Mailing Address - Fax:720-502-7029
Practice Address - Street 1:941 S HAVANA ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3042
Practice Address - Country:US
Practice Address - Phone:303-341-5313
Practice Address - Fax:303-363-1272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00201827261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental