Provider Demographics
NPI:1174626766
Name:BROWN, WILLIAM M JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:BROWN
Suffix:JR
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 1:1002 N CHURCH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401
Mailing Address - Country:US
Mailing Address - Phone:336-275-6600
Mailing Address - Fax:336-275-6699
Practice Address - Street 1:1002 N CHURCH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-275-6600
Practice Address - Fax:336-275-6699
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3985122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8991149Medicaid
NC91149OtherBCBS NC