Provider Demographics
NPI:1083774418
Name:BROWN, THOMAS F (DDS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:F
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 1:1807 S WASHINGTON ST STE 107
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-2050
Mailing Address - Country:US
Mailing Address - Phone:630-369-3120
Mailing Address - Fax:
Practice Address - Street 1:1807 S WASHINGTON ST STE 107
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-2050
Practice Address - Country:US
Practice Address - Phone:630-369-3120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL190191471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice