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General NPI Number Information
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NPI Number | 1205421583
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Entity Type | Individual
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Provider Name | PIERPONT FLANDERS BROWN IV DMD
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Gender | Male
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Dates
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Enumeration Date | 03/08/2021
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 4031 EXECUTIVE DR STE 100
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City | OAKWOOD
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State | GA
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Zip | 30566-2829
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Country | US
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Telephone | 770-503-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 1820 BLUE RIDGE DR NE
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City | GAINESVILLE
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State | GA
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Zip | 30501-1210
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Country | US
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Telephone | 770-403-0259
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN122473
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License Number State | GA
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