Individual
ERIC JOSEPH BRAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1149 BOUGHTON ST BLDG B, WATERTOWN, WI 53094-3104
(920) 261-0495
Mailing address
7926 30TH AVE, KENOSHA, WI 53142-4612
(262) 705-7967
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
60015200-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/02/2024
Last updated
06/01/2024
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