Provider Demographics
NPI:1114377694
Name:BROWN, TAMRA LEANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:TAMRA
Middle Name:LEANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:TAMRA
Other - Middle Name:LEANN
Other - Last Name:CULP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1355 37TH ST STE 401
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-7322
Mailing Address - Country:US
Mailing Address - Phone:772-569-9700
Mailing Address - Fax:772-569-9704
Practice Address - Street 1:1355 37TH ST STE 401
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-7322
Practice Address - Country:US
Practice Address - Phone:772-569-9700
Practice Address - Fax:772-569-9704
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN219171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice