Healthcare Provider Details

I. General information

NPI: 1821772187
Provider Name (Legal Business Name): THOMAS PARKER BROWN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 FRANKLIN RD STE 104
BRENTWOOD TN
37027-5250
US

IV. Provider business mailing address

343 FRANKLIN RD STE 104
BRENTWOOD TN
37027-5250
US

V. Phone/Fax

Practice location:
  • Phone: 615-373-2045
  • Fax:
Mailing address:
  • Phone: 615-373-2045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number12175
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: