Provider Demographics
NPI:1689698664
Name:BROWN, VAN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:VAN
Middle Name:M
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 E 35TH ST
Mailing Address - Street 2:SUITE #2-A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3887
Mailing Address - Country:US
Mailing Address - Phone:212-685-4217
Mailing Address - Fax:212-685-1366
Practice Address - Street 1:20 E 35TH ST
Practice Address - Street 2:SUITE #2-A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3887
Practice Address - Country:US
Practice Address - Phone:212-685-4217
Practice Address - Fax:212-685-1366
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0439211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice