Provider Demographics
NPI:1588782429
Name:BRAKOVEC, JOSPEH WARREN (DDS)
Entity type:Individual
Prefix:
First Name:JOSPEH
Middle Name:WARREN
Last Name:BRAKOVEC
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 CENTER PARK DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-2116
Mailing Address - Country:US
Mailing Address - Phone:865-966-0500
Mailing Address - Fax:865-966-0502
Practice Address - Street 1:215 CENTER PARK DRIVE
Practice Address - Street 2:SUITE 500
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-2100
Practice Address - Country:US
Practice Address - Phone:865-966-0500
Practice Address - Fax:865-966-0502
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS83031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice