Provider Demographics
NPI:1295867240
Name:BROWN, DAVID C (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
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 1:2575 CEANOTHUS AVE
Mailing Address - Street 2:STE.160
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-7615
Mailing Address - Country:US
Mailing Address - Phone:530-343-7306
Mailing Address - Fax:530-343-7305
Practice Address - Street 1:2575 CEANOTHUS AVE
Practice Address - Street 2:STE.160
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-7615
Practice Address - Country:US
Practice Address - Phone:530-343-7306
Practice Address - Fax:530-343-7305
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA411621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice