Organization
RICHARD A. BRAZON DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ALAN BRAZON DDS (OWNER)
(570) 347-2046
Entity
Organization
Contact information
Practice address
2611 PITTSTON AVE, SCRANTON, PA 18505-3217
(570) 347-2046
Mailing address
2611 PITTSTON AVE, SCRANTON, PA 18505-3217
(570) 347-2046
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS021659L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014987280001
—
PA
Enumeration date
10/31/2007
Last updated
10/31/2007
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