Provider Demographics
NPI:1487761524
Name:BRAUN, RONALD (DDS)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:BRAUN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 E MAIN ST
Mailing Address - Street 2:SUITE 316
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2871
Mailing Address - Country:US
Mailing Address - Phone:631-724-0327
Mailing Address - Fax:631-724-0350
Practice Address - Street 1:222 E MAIN ST
Practice Address - Street 2:SUITE 316
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2871
Practice Address - Country:US
Practice Address - Phone:631-724-0327
Practice Address - Fax:631-780-6528
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038463122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist