Individual
RYAN THOMAS BRADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 BROAD ST, SUITE 203, LAKE GENEVA, WI 53147-2000
(262) 248-0120
(262) 249-0140
Mailing address
101 BROAD ST, SUITE 203, LAKE GENEVA, WI 53147-2000
(262) 248-0120
(262) 249-0140
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5908
WI
Other
Enumeration date
09/16/2008
Last updated
09/16/2008
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