Individual
RAJ BRAHMBHATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3533 N SHILOH DR, SUITE 3, FAYETTEVILLE, AR 72703-5359
(479) 445-6335
(479) 301-2878
Mailing address
4375 N VANTAGE DR, SUITE 202, FAYETTEVILLE, AR 72703-4982
(479) 445-6335
(479) 301-2878
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4063
AR
Other
Enumeration date
07/08/2015
Last updated
07/08/2015
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