Individual
DR. BRIAN TIMOTHY BRACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1121 BROAD ST, SUMTER, SC 29150-1902
(201) 919-1950
Mailing address
31 FROGMORE RD, MT PLEASANT, SC 29464-6651
(201) 919-1950
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401418752
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DGD8524
SC
Other
Enumeration date
10/15/2012
Last updated
02/02/2024
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