Provider Demographics
NPI:1457460305
Name:BROWN, ROGER H (DMD)
Entity Type:Individual
Prefix:MR
First Name:ROGER
Middle Name:H
Last Name:BROWN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ROUTE 206
Mailing Address - Street 2:UNIT 30
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844
Mailing Address - Country:US
Mailing Address - Phone:908-359-0666
Mailing Address - Fax:908-281-7735
Practice Address - Street 1:601 ROUTE 206
Practice Address - Street 2:UNIT 30
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844
Practice Address - Country:US
Practice Address - Phone:908-359-0666
Practice Address - Fax:908-281-7735
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ13232122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist