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NPI Code Detail

MEDICARE: DR. DENISE ALLEN BROWN D.M.D.

MEDICARE: DR. DENISE ALLEN BROWN D.M.D.
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
1122300000XDentistGA011678GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1011678OTHERGASTATE LISCENCE

General Provider Information

NPI Number : 1588669089
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DENISE ALLEN BROWN D.M.D.
Provider Business Mailing Address
First Line : 4000 SMITHTOWN RD
Second Line : SUITE 150
City : SUWANEE
State : GA
Zip : 30024-6559
Country : US
Telephone Number : 770-932-4404
Fax Number :
Provider Business Practice Location Address
First Line : 4000 SMITHTOWN RD
Second Line : STE 150
City : SUWANEE
State : GA
Zip : 30024-6560
Country : US
Telephone Number : 770-932-4404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 07/08/2007

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