Provider Demographics
NPI:1710188560
Name:BROWN, AMANDA E (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:E
Last Name:BROWN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CARDINAL PARK DR SE
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-4448
Mailing Address - Country:US
Mailing Address - Phone:703-777-8777
Mailing Address - Fax:703-777-6901
Practice Address - Street 1:2 CARDINAL PARK DR SE
Practice Address - Street 2:SUITE 201A
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-4448
Practice Address - Country:US
Practice Address - Phone:703-777-8777
Practice Address - Fax:703-777-6901
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010088671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice