Healthcare Provider Details

I. General information

NPI: 1326429762
Provider Name (Legal Business Name): SHAYLA BROWNER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 06/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2607 GILLIONVILLE RD
ALBANY GA
31707-3003
US

IV. Provider business mailing address

204 N WESTOVER BLVD
ALBANY GA
31707-2983
US

V. Phone/Fax

Practice location:
  • Phone: 229-883-9001
  • Fax: 229-888-3342
Mailing address:
  • Phone: 229-888-6559
  • Fax: 229-436-4107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN014965
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN014965
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: