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General NPI Number Information
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NPI Number | 1417528761
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Entity Type | Organization
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Legal Business Name | JESSICA S BROWN DMD LLC
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Dates
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Enumeration Date | 07/08/2021
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Last Update Date | 07/08/2021
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Provider Practice Location Address
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Address Line | 1108 FETNER DR
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City | AMERICUS
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State | GA
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Zip | 31709-3774
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Country | US
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Telephone | 229-924-4479
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Fax | 229-924-4391
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Provider Business Mailing Address
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Address Line | 1108 FETNER DR
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City | AMERICUS
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State | GA
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Zip | 31709-3774
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Country | US
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Telephone | 229-924-4479
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Fax | 229-924-4391
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. JESSICA SMITH BROWN
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Credential | DMD
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Telephone | 229-924-4479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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