Provider Demographics
NPI:1689718157
Name:BROWN, JARROD H (DDS)
Entity Type:Individual
Prefix:DR
First Name:JARROD
Middle Name:H
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 1:378 SAVANNAH AVE
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-5163
Mailing Address - Country:US
Mailing Address - Phone:912-764-4403
Mailing Address - Fax:912-764-7210
Practice Address - Street 1:378 SAVANNAH AVE
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-5163
Practice Address - Country:US
Practice Address - Phone:912-764-4403
Practice Address - Fax:912-764-7210
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010087831223G0001X
GADN015578122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice