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General NPI Number Information
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NPI Number | 1851381867
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Entity Type | Individual
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Provider Name | MATTHEW B BROWN M.D., D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/21/2005
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 451 W CHURCH ST
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City | ELMIRA
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State | NY
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Zip | 14901-2636
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Country | US
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Telephone | 607-733-3760
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Fax | 607-734-6000
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Provider Business Mailing Address
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Address Line | 451 W CHURCH ST
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City | ELMIRA
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State | NY
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Zip | 14901-2636
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Country | US
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Telephone |
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Fax |
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 199781-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 045766-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS030040L
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 22DI01920900
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License Number State | NJ
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