Braasch, Bradley Owen

Braasch, Bradley Owen is an sole proprietor health care provider with primary practice located at 1804 N Cleburn St , Grand Island NE 68801-3539. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Braasch, Bradley Owen can be contacted via phone (308) 381-4995.

Contact Information

Primary practice address
1804 N Cleburn St Grand Island NE 68801-3539
Phone: (308) 381-4995
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 5936 Nebraska

Profile Details

NPI number 1770565202
LBN Legal business name Braasch, Bradley Owen
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 18th, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770565202 NPPES
Nebraska MEDICAID 91-181042700

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