Provider Demographics
NPI:1073607347
Name:BROWN, DAVID ALAN (DDS)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALAN
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:2401 ORANGEBURG AVE
Mailing Address - Street 2:SUITE 675
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-3351
Mailing Address - Country:US
Mailing Address - Phone:209-612-7375
Mailing Address - Fax:
Practice Address - Street 1:3605 HOSPITAL ROAD
Practice Address - Street 2:SUITE H
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-5173
Practice Address - Country:US
Practice Address - Phone:209-381-2047
Practice Address - Fax:209-381-2045
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAD393731223G0001X
CAGA994207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology