Provider Demographics
NPI:1497593842
Name:BRANZER, RACHEL ANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ANNE
Last Name:BRANZER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 SOUTH AVE # 5812
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-5812
Mailing Address - Country:US
Mailing Address - Phone:203-966-5944
Mailing Address - Fax:
Practice Address - Street 1:208 SOUTH AVE # 5812
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-5812
Practice Address - Country:US
Practice Address - Phone:203-966-5944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0641491223G0001X
CT142311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice