Provider Demographics
NPI:1013804087
Name:BROWN, ETHAN WILLIAM (DDS)
Entity type:Individual
Prefix:
First Name:ETHAN
Middle Name:WILLIAM
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10025 151ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:BATHGATE
Mailing Address - State:ND
Mailing Address - Zip Code:58216-9636
Mailing Address - Country:US
Mailing Address - Phone:701-521-0907
Mailing Address - Fax:
Practice Address - Street 1:1589 SKEET CLUB RD STE 150
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8820
Practice Address - Country:US
Practice Address - Phone:336-450-2078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program