Provider Demographics
NPI:1770528598
Name:BRAJEVIC, FRANK JOHN (DDS)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOHN
Last Name:BRAJEVIC
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:712 VIA DEL MONTE
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-1612
Mailing Address - Country:US
Mailing Address - Phone:310-378-1673
Mailing Address - Fax:310-378-1673
Practice Address - Street 1:VA WEST LOS ANGELES, 11301 WILSHIRE BLVD
Practice Address - Street 2:DENTAL SERVICE W-160
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073
Practice Address - Country:US
Practice Address - Phone:310-478-3711
Practice Address - Fax:310-268-3941
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA382621223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics