Provider Demographics
NPI:1609224344
Name:BROWN, NUSI PECZI (DMD)
Entity Type:Individual
Prefix:
First Name:NUSI
Middle Name:PECZI
Last Name:BROWN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 TILLEY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-4450
Mailing Address - Country:US
Mailing Address - Phone:802-863-3950
Mailing Address - Fax:
Practice Address - Street 1:180 GROVE ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-2904
Practice Address - Country:US
Practice Address - Phone:802-342-1939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-02
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016.0121682122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist