Provider Demographics
NPI:1023215746
Name:HENRY J. BROWN, D.D.S.P.C.
Entity Type:Organization
Organization Name:HENRY J. BROWN, D.D.S.P.C.
Other - Org Name:BROWN FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:269-963-5044
Mailing Address - Street 1:195 COLUMBIA AVE E
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-3734
Mailing Address - Country:US
Mailing Address - Phone:269-963-5044
Mailing Address - Fax:269-963-2221
Practice Address - Street 1:195 COLUMBIA AVE E
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-3734
Practice Address - Country:US
Practice Address - Phone:269-963-5044
Practice Address - Fax:269-963-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010146951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty