Provider Demographics
NPI:1376604306
Name:BROWN, BREGETTA TRINACE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BREGETTA
Middle Name:TRINACE
Last Name:BROWN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:B
Other - Middle Name:TRINACE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:13034 E ELGIN DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-4457
Mailing Address - Country:US
Mailing Address - Phone:303-373-1272
Mailing Address - Fax:
Practice Address - Street 1:4143 S JULIAN WAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80236-3101
Practice Address - Country:US
Practice Address - Phone:303-866-7346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHD1046631223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health