Healthcare Provider Details
I. General information
NPI: 1780612705
Provider Name (Legal Business Name): KATHLEEN HERB BROWER DMD, MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/29/2006
Last Update Date: 11/05/2021
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3655 ROUTE 202 GEORGETOWN CROSSINGS, STE 210
DOYLESTOWN PA
18901-6601
US
IV. Provider business mailing address
3655 ROUTE 202 GEORGETOWN CROSSINGS, STE 210
DOYLESTOWN PA
18901-6601
US
V. Phone/Fax
- Phone: 215-794-7976
- Fax: 215-794-7976
- Phone: 215-794-7976
- Fax: 215-794-7976
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223S0112X |
| Taxonomy | Oral and Maxillofacial Surgery (Dentist) |
| License Number | DS028192L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: