=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396917126
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WILLIAM E BROWN DDS LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/01/2008
-----------------------------------------------------
Last Update Date | 04/01/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 549 E BRAMBLETON AVE STE 11
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-622-8884
-----------------------------------------------------
Fax | 757-622-1367
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 549 E BRAMBLETON AVE STE 11
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-622-8884
-----------------------------------------------------
Fax | 757-622-1367
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST
-----------------------------------------------------
Name | DR. WILLIAM E BROWN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 757-622-8884
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 0401005815
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------