MEDICARE: DR. CHARLES E BROWN DDS

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	1223G0001X	General Practice Dentistry	2845	ME

General Provider Information

NPI Number	:	1174555353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES E BROWN DDS

Provider Business Mailing Address
First Line	:	PO BOX 1520
Second Line	:
City	:	NAPLES
State	:	ME
Zip	:	04055
Country	:	US
Telephone Number	:	207-693-3572
Fax Number	:	207-693-3636

Provider Business Practice Location Address
First Line	:	713 ROOSEVELT TRAIL
Second Line	:
City	:	NAPLES
State	:	ME
Zip	:	04055
Country	:	US
Telephone Number	:	207-693-3572
Fax Number	:	207-693-3636

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	07/08/2007

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