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General NPI Number Information
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NPI Number | 1235292897
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Entity Type | Individual
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Provider Name | SHELTON BENEE BROWN DDS
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Gender | Male
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 03/16/2009
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Provider Practice Location Address
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Address Line | 2151 FOUNTAIN DR 206
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City | SNELLVILLE
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State | GA
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Zip | 30078-6783
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Country | US
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Telephone | 678-344-1888
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Fax | 678-344-1847
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Provider Business Mailing Address
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Address Line | 2379 WALKER DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-6019
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Country | US
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Telephone | 678-377-6101
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Fax | 678-344-1847
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DNO12329
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License Number State | GA
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