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General NPI Number Information
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NPI Number | 1871064709
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Entity Type | Individual
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Provider Name | EZRA JARED BROWN DMD, MS
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Gender | Male
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 33 N MAIN ST
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City | MARLBORO
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State | NJ
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Zip | 07746-1470
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Country | US
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Telephone | 732-577-0075
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Fax |
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Provider Business Mailing Address
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Address Line | 96 OTTOWA RD S
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City | MARLBORO
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State | NJ
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Zip | 07746-1246
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Country | US
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Telephone | 908-692-5586
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 22D102642000
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License Number State | NJ
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