Provider Demographics
NPI:1831318062
Name:BROWN, JENNIE CAROL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNIE
Middle Name:CAROL
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 1:369 IVORY CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-9078
Mailing Address - Country:US
Mailing Address - Phone:720-427-9518
Mailing Address - Fax:303-755-6703
Practice Address - Street 1:1344 S CHAMBERS RD
Practice Address - Street 2:#203
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-4096
Practice Address - Country:US
Practice Address - Phone:303-755-6700
Practice Address - Fax:303-755-6703
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO76971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice