Organization
BRADEN DENTAL CENTER SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK THOMAS BRADEN DDS (OWNER OF BRADEN DENTAL CENTER)
(262) 248-0120
Entity
Organization
Contact information
Practice address
101 BROAD ST, STE 203, LAKE GENEVA, WI 53147
(262) 248-0120
(262) 249-0140
Mailing address
101 BROAD ST, STE 203, LAKE GENEVA, WI 53147
(262) 248-0120
(262) 249-0140
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2499
WI
Other
Enumeration date
05/01/2007
Last updated
09/09/2015
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