Individual
DR. MARK WINSTON BRAITHWAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.A.
Contact information
Practice address
950 CAMPBELL AVE, VA CONNECTICUT HEALTHCARE SYSTEM, DENTAL SERVICE 160, WEST HAVEN, CT 06516-2770
(203) 932-5711
(203) 937-4895
Mailing address
159 MIDWOOD ST, BROOKLYN, NY 11225-5060
(718) 287-6756
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
19024487
IL
Other
Enumeration date
10/06/2006
Last updated
07/08/2007
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