MEDICARE: DR. DEBORAH E BROWN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DI021688	NJ

General Provider Information

NPI Number	:	1033138847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH E BROWN DMD

Provider Business Mailing Address
First Line	:	101 2ND ST
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-3324
Country	:	US
Telephone Number	:	732-363-6655
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 2ND ST
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-3324
Country	:	US
Telephone Number	:	732-363-6655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	12/29/2011

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