Provider Demographics
NPI:1598154122
Name:ELIJAH BROWN FAMILY DENTAL CARE, PLLC
Entity Type:Organization
Organization Name:ELIJAH BROWN FAMILY DENTAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIKKI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PIRRONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-758-7745
Mailing Address - Street 1:1097 WESTON DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3493
Mailing Address - Country:US
Mailing Address - Phone:615-758-7745
Mailing Address - Fax:615-758-7651
Practice Address - Street 1:1097 WESTON DR
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3493
Practice Address - Country:US
Practice Address - Phone:615-758-7745
Practice Address - Fax:615-758-7651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty