MEDICARE: DAVID R BROWN DDS PS

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	8500	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821134230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID R BROWN DDS PS

Provider Business Mailing Address
First Line	:	1014 S 40TH AVE
Second Line	:
City	:	YAKIMA
State	:	WA
Zip	:	98908-3804
Country	:	US
Telephone Number	:	509-966-0303
Fax Number	:	509-966-2140

Provider Business Practice Location Address
First Line	:	1014 S 40TH AVE
Second Line	:
City	:	YAKIMA
State	:	WA
Zip	:	98908-3804
Country	:	US
Telephone Number	:	509-966-0303
Fax Number	:	509-966-2140

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID R BROWN
Credential	:	DDS
Telephone Number	:	509-966-0303

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	12/22/2016

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