Provider Demographics
NPI:1710008636
Name:BROWN, THOMAS A (DMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:BROWN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:16525 HOLLY CREST LN
Mailing Address - Street 2:SUITE 250
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-4909
Mailing Address - Country:US
Mailing Address - Phone:704-892-3300
Mailing Address - Fax:704-892-3317
Practice Address - Street 1:16525 HOLLY CREST LN
Practice Address - Street 2:SUITE 250
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-4909
Practice Address - Country:US
Practice Address - Phone:704-892-3300
Practice Address - Fax:704-892-3317
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics