Provider Demographics
NPI:1487836912
Name:BROWN, JAMES W JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10360 MEDLOCK BRIDGE RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5927
Mailing Address - Country:US
Mailing Address - Phone:770-623-1198
Mailing Address - Fax:770-623-0182
Practice Address - Street 1:10360 MEDLOCK BRIDGE RD
Practice Address - Street 2:SUITE D
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-5927
Practice Address - Country:US
Practice Address - Phone:770-623-1198
Practice Address - Fax:770-623-0182
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GADNO102081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice