Provider Demographics
NPI:1609088913
Name:BROWN, ROBERT SHERMAN (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:SHERMAN
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5615 ATLANTIC AVENUE
Mailing Address - Street 2:
Mailing Address - City:VENTNOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08406-2896
Mailing Address - Country:US
Mailing Address - Phone:609-822-9539
Mailing Address - Fax:
Practice Address - Street 1:5615 ATLANTIC AVENUE
Practice Address - Street 2:
Practice Address - City:VENTNOR
Practice Address - State:NJ
Practice Address - Zip Code:08406-2896
Practice Address - Country:US
Practice Address - Phone:609-822-6152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI00667900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist