Provider Demographics
NPI:1558695106
Name:TANYA A. BROWN, D.M.D., LLC
Entity Type:Organization
Organization Name:TANYA A. BROWN, D.M.D., LLC
Other - Org Name:THE CENTER FOR COSMETIC & RESTORATIVE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:757-546-5262
Mailing Address - Street 1:129 HANBURY RD W STE 101
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-4283
Mailing Address - Country:US
Mailing Address - Phone:757-546-5262
Mailing Address - Fax:757-546-5265
Practice Address - Street 1:129 HANBURY RD W STE 101
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-4283
Practice Address - Country:US
Practice Address - Phone:757-546-5262
Practice Address - Fax:757-546-5265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty