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Individual

ROBERT E. BRAUN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
3303 TRIER RD, FORT WAYNE, IN 46815-4768
(260) 484-9990
(260) 484-6573
Mailing address
3303 TRIER RD, FORT WAYNE, IN 46815-4768
(260) 484-9990
(260) 484-6573

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
12009838
IN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901016892
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000086696
BCBS/ANTHEM
IN
05
200147440
IN
Enumeration date
07/19/2006
Last updated
02/12/2013
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