Provider Demographics
NPI:1851448914
Name:BROWN, CARSON VICTOR II (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARSON
Middle Name:VICTOR
Last Name:BROWN
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:550 MCELHATTAN DRIVE
Mailing Address - Street 2:BOX 450
Mailing Address - City:MCELHATTAN
Mailing Address - State:PA
Mailing Address - Zip Code:17748
Mailing Address - Country:US
Mailing Address - Phone:570-769-9130
Mailing Address - Fax:570-769-9133
Practice Address - Street 1:550 MCELHATTAN DRIVE
Practice Address - Street 2:BOX 450
Practice Address - City:MCELHATTAN
Practice Address - State:PA
Practice Address - Zip Code:17748
Practice Address - Country:US
Practice Address - Phone:570-769-9130
Practice Address - Fax:570-769-9133
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-026291-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice