Individual
DR. STANTON MARC BRAID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D. M.D.
Contact information
Practice address
1521 LOCUST ST, SUITE 600, PHILA, PA 19102-3727
(215) 735-6241
(215) 735-6242
Mailing address
1521 LOCUST ST, SUITE 600, PHILA, PA 19102-3727
(215) 735-6241
(215) 735-6242
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS018002L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005238080001
—
PA
01
—
0060873000
PA BC-BS- KHPE-PERSONALCH
PA
Enumeration date
10/12/2005
Last updated
03/13/2016
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