Provider Demographics
NPI:1851921068
Name:BROWDER FAMILY DENTISTRY
Entity Type:Organization
Organization Name:BROWDER FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-292-0502
Mailing Address - Street 1:489 POST RD E
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4435
Mailing Address - Country:US
Mailing Address - Phone:203-254-8008
Mailing Address - Fax:
Practice Address - Street 1:489 POST RD E
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4435
Practice Address - Country:US
Practice Address - Phone:203-254-8008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1154735009Medicaid