MEDICARE: DR JENNIE BROWN DDS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	7697	CO

General Provider Information

NPI Number	:	1194725903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR JENNIE BROWN DDS PC

Provider Business Mailing Address
First Line	:	1344 S CHAMBERS RD
Second Line	:	#203
City	:	AURORA
State	:	CO
Zip	:	80017-4096
Country	:	US
Telephone Number	:	303-755-6700
Fax Number	:	303-755-6703

Provider Business Practice Location Address
First Line	:	1344 S CHAMBERS RD
Second Line	:	#203
City	:	AURORA
State	:	CO
Zip	:	80017-4096
Country	:	US
Telephone Number	:	303-755-6700
Fax Number	:	303-755-6703

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JENNIE CAROL BROWN
Credential	:	DDS
Telephone Number	:	303-755-6700

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	08/22/2020

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