MEDICARE: THOMAS A. BROWN DDS, PLLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1093411456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS A. BROWN DDS, PLLC

Provider Business Mailing Address
First Line	:	601 RIVERINE DR APT 204
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-3200
Country	:	US
Telephone Number	:	574-527-8399
Fax Number	:

Provider Business Practice Location Address
First Line	:	1208 E EIGHTH ST
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-2939
Country	:	US
Telephone Number	:	574-527-8399
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. THOMAS BROWN
Credential	:	DDS
Telephone Number	:	574-527-8399

Provider Enumeration Date	:	02/06/2023
Last Update Date	:	02/06/2023

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