Provider Demographics
NPI:1639372501
Name:BROWN, ROLAND MERRITT JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:MERRITT
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:58 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-4250
Mailing Address - Country:US
Mailing Address - Phone:973-538-9880
Mailing Address - Fax:973-984-1974
Practice Address - Street 1:58 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-4250
Practice Address - Country:US
Practice Address - Phone:973-538-9880
Practice Address - Fax:973-984-1974
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ117371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice