Provider Demographics
NPI:1649390642
Name:BROWELEIT, DAVID LOREN (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LOREN
Last Name:BROWELEIT
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 N 200TH ST
Mailing Address - Street 2:223
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3213
Mailing Address - Country:US
Mailing Address - Phone:206-542-7563
Mailing Address - Fax:206-546-6303
Practice Address - Street 1:1207 N 200TH ST
Practice Address - Street 2:223
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3213
Practice Address - Country:US
Practice Address - Phone:206-542-7563
Practice Address - Fax:206-546-6303
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000044741223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics