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General NPI Number Information
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NPI Number | 1649737313
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Entity Type | Organization
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Legal Business Name | NICHOLAS BROWN DDS PC
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Dates
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Enumeration Date | 02/28/2019
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 235 S RIDGE STREET SUITE 2B
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City | BRECKENRIDGE
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State | CO
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Zip | 80424
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Country | US
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Telephone | 970-688-4782
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1817
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City | BRECKENRIDGE
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State | CO
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Zip | 80424-1817
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Country | US
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Telephone | 970-688-4782
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Fax | 970-453-7575
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Authorized Official
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Title or Position | DENTIST
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Name | NICHOLAS BROWN
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Credential | DDS
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Telephone | 719-539-3145
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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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