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General NPI Number Information
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NPI Number | 1235804071
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Entity Type | Organization
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Legal Business Name | ALLA. V. BROWN, D.M.D., P.C.
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Dates
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Enumeration Date | 08/13/2021
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 5348 LANIER ISLANDS PKWY
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City | BUFORD
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State | GA
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Zip | 30518-9026
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Country | US
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Telephone | 678-714-9199
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Fax | 678-714-9398
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Provider Business Mailing Address
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Address Line | 5348 LANIER ISLANDS PKWY
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City | BUFORD
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State | GA
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Zip | 30518-9026
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Country | US
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Telephone | 678-714-9199
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Fax | 678-714-9398
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. SUSANNAH E PRESTRIDGE
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Credential |
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Telephone | 678-714-9199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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