Healthcare Provider Details

I. General information

NPI: 1053896969
Provider Name (Legal Business Name): NATALIE W BROWN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2018
Last Update Date: 09/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6855 S 27TH ST
FRANKLIN WI
53132-8045
US

IV. Provider business mailing address

1141 N OLD WORLD 3RD ST
MILWAUKEE WI
53203-1116
US

V. Phone/Fax

Practice location:
  • Phone: 414-435-0787
  • Fax: 414-435-5999
Mailing address:
  • Phone: 515-480-8787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1001943
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: