Provider Demographics
NPI:1154434454
Name:BRAFMAN, MARK H (DMD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:H
Last Name:BRAFMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 US HIGHWAY 46
Mailing Address - Street 2:EQUITY PLAZA, SUITE 3A
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-3206
Mailing Address - Country:US
Mailing Address - Phone:973-691-1200
Mailing Address - Fax:
Practice Address - Street 1:382 US HIGHWAY 46
Practice Address - Street 2:EQUITY PLAZA, SUITE 3A
Practice Address - City:BUDD LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07828-3206
Practice Address - Country:US
Practice Address - Phone:973-691-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI010825001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice