Provider Demographics
NPI:1154322782
Name:BROWN, DONALD R (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:R
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 1:3340 EMMAUS RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-2685
Mailing Address - Country:US
Mailing Address - Phone:540-433-2613
Mailing Address - Fax:540-433-5166
Practice Address - Street 1:3340 EMMAUS RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-2685
Practice Address - Country:US
Practice Address - Phone:540-433-2613
Practice Address - Fax:540-433-5166
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-04
Last Update Date:2007-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401003932122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist