Provider Demographics
NPI:1417788316
Name:BRAUN, VALERIE (RDH)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:BRAUN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 ALCAN DR
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-8755
Mailing Address - Country:US
Mailing Address - Phone:608-393-7166
Mailing Address - Fax:
Practice Address - Street 1:238 FRONT ST
Practice Address - Street 2:
Practice Address - City:CASHTON
Practice Address - State:WI
Practice Address - Zip Code:54619-2002
Practice Address - Country:US
Practice Address - Phone:608-654-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10977-16124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist