Provider Demographics
NPI:1326290214
Name:BROWN DENTAL CARE LTD
Entity Type:Organization
Organization Name:BROWN DENTAL CARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:217-774-4221
Mailing Address - Street 1:101 W NORTH 1ST ST
Mailing Address - Street 2:P O BOX 109
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62565-1522
Mailing Address - Country:US
Mailing Address - Phone:217-774-4221
Mailing Address - Fax:
Practice Address - Street 1:101 W N 1ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILE
Practice Address - State:IL
Practice Address - Zip Code:62565
Practice Address - Country:US
Practice Address - Phone:217-774-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty