Healthcare Provider Details

I. General information

NPI: 1598020331
Provider Name (Legal Business Name): SARAH BROWN BRUNSON DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ALLISON BROWN DMD

II. Dates (important events)

Enumeration Date: 07/09/2012
Last Update Date: 07/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 N SHIRLEY AVE
HONEA PATH SC
29654-1636
US

IV. Provider business mailing address

105 LOCHENSHIRE PL
BELTON SC
29627-8295
US

V. Phone/Fax

Practice location:
  • Phone: 864-369-2966
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8077
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: