Provider Demographics
NPI:1548007339
Name:BRAUN, STEPHANIE BROOKE (DMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:BROOKE
Last Name:BRAUN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 HAMILTON DR
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-3119
Mailing Address - Country:US
Mailing Address - Phone:267-600-1348
Mailing Address - Fax:
Practice Address - Street 1:19 HARKER AVE
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009-2331
Practice Address - Country:US
Practice Address - Phone:856-768-3332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI03051500122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist