Provider Demographics
NPI:1043323975
Name:BRAMER, GARY ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:ALAN
Last Name:BRAMER
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 1:35 WOODS RD
Mailing Address - Street 2:
Mailing Address - City:OMAK
Mailing Address - State:WA
Mailing Address - Zip Code:98841-9573
Mailing Address - Country:US
Mailing Address - Phone:509-826-2744
Mailing Address - Fax:509-826-2744
Practice Address - Street 1:706 OKOMA DR
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841-9593
Practice Address - Country:US
Practice Address - Phone:509-826-2744
Practice Address - Fax:509-826-2744
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA53941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice