Provider Demographics
NPI:1003961079
Name:BROWN, JACQUELINE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8737 COLESVILLE RD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3928
Mailing Address - Country:US
Mailing Address - Phone:301-587-8750
Mailing Address - Fax:301-587-8753
Practice Address - Street 1:8737 COLESVILLE RD
Practice Address - Street 2:SUITE #301
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3928
Practice Address - Country:US
Practice Address - Phone:301-587-8750
Practice Address - Fax:301-587-8753
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD90251223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics