IndividualActive
Jack Brauer, DDS
NPI 1407187362 · General Practice Dentistry · Midway, UT
Provider details
- NPI number
- 1407187362
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- License
- 47988549921 (UT)
Specialties & taxonomies
Dental Providers
Practice location
450 Bern Way
Midway, UT 84049
Phone: (619) 840-7080
Approximate (ZIP-level) locationGet directions
Mailing address
450 Bern Way
Midway, UT 84049
Registry dates
- Enumerated
- 2010-01-15
- Last updated
- 2022-05-20
- Certified
- 2022-05-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.