DR. Phillip Wayne Bracken, DDS

NPI #1477651198 in Mableton, Georgia

Provider Information

NPI Number
1477651198
Entity Type
Individual
Name
DR. Phillip Wayne Bracken, DDS
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - General Practice
Credential
DDS
Enumeration Date
Sep 20, 2006
Last Updated
Jul 8, 2007

Practice Location

Address
5345 FLOYD RD SW
Address 2
SUITE M
State
Georgia
ZIP Code
30126-2270
Phone
(770) 944-8620

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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Organizations

Provider Name
Mahant Dental LLC

Part of Mahant Dental LLC

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