Provider Demographics
NPI:1477611416
Name:BROWN, MICHELLE BRIDGET (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:BRIDGET
Last Name:BROWN
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:BRIDGET
Other - Last Name:BROWN-SLUSARZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1010 G A R HWY
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-4566
Mailing Address - Country:US
Mailing Address - Phone:508-679-5291
Mailing Address - Fax:508-679-9200
Practice Address - Street 1:1010 G A R HWY
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-4566
Practice Address - Country:US
Practice Address - Phone:508-679-5291
Practice Address - Fax:508-679-9200
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA207261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics