Provider Demographics
NPI:1912000415
Name:CHARLES H BROWN III DDS PC
Entity Type:Organization
Organization Name:CHARLES H BROWN III DDS PC
Other - Org Name:HAYFIELD DENTAL CARE KINGSTOWNE ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:H
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-971-2220
Mailing Address - Street 1:7574 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315
Mailing Address - Country:US
Mailing Address - Phone:703-971-2220
Mailing Address - Fax:703-971-2637
Practice Address - Street 1:7574 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315
Practice Address - Country:US
Practice Address - Phone:703-971-2220
Practice Address - Fax:703-971-2637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty