MEDICARE: DR. RICHARD CLINTON BROWN DDS

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	122300000X	Dentist	23282	CA

General Provider Information

NPI Number	:	1821110842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD CLINTON BROWN DDS

Provider Business Mailing Address
First Line	:	6600 MADISON AVE STE 5
Second Line	:
City	:	CARMICHAEL
State	:	CA
Zip	:	95608-0645
Country	:	US
Telephone Number	:	916-966-9017
Fax Number	:

Provider Business Practice Location Address
First Line	:	6600 MADISON AVE STE 5
Second Line	:
City	:	CARMICHAEL
State	:	CA
Zip	:	95608-0645
Country	:	US
Telephone Number	:	916-966-9017
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	05/16/2008

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