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Organization

BRAVMAN LANGSTON AND ASSOCIATES ORAL & MAXILLOFACIAL SURGERY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD J. BRAVMAN DMD, MS (OWNER)
(508) 771-6665
Entity
Organization

Contact information

Practice address
68 CAMP STREET, HYANNIS, MA 02061
(508) 771-6665
Mailing address
68 CAMP STREET, HYANNIS, MA 02061
(508) 771-6665

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DX9762
MEDICARE PTAN GROUP
MA
01
X04486
BCBS IND. #
MA
01
X11180
BCBS
MA
Enumeration date
04/04/2008
Last updated
12/11/2017
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