Provider Demographics
NPI:1366617045
Name:DOUGLAS E. BRAMMER, D.D.S., INC.
Entity type:Organization
Organization Name:DOUGLAS E. BRAMMER, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-256-7892
Mailing Address - Street 1:120 WEST DELAWARE AVE #B
Mailing Address - Street 2:
Mailing Address - City:VINITA
Mailing Address - State:OK
Mailing Address - Zip Code:74301-4224
Mailing Address - Country:US
Mailing Address - Phone:918-256-7892
Mailing Address - Fax:
Practice Address - Street 1:120 W DELAWARE AVE # B
Practice Address - Street 2:
Practice Address - City:VINITA
Practice Address - State:OK
Practice Address - Zip Code:74301-4224
Practice Address - Country:US
Practice Address - Phone:918-256-7892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3869122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty