MEDICARE: JULIA EILEEN 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	55044	CA

General Provider Information

NPI Number	:	1871713842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA EILEEN BROWN DDS

Provider Business Mailing Address
First Line	:	6331 HAVEN BLVD #12
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91737
Country	:	US
Telephone Number	:	909-989-7222
Fax Number	:	909-989-7227

Provider Business Practice Location Address
First Line	:	6331 HAVEN BLVD #12
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91737
Country	:	US
Telephone Number	:	909-989-7222
Fax Number	:	909-989-7227

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

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	02/03/2014

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