Provider Demographics
NPI:1942363387
Name:BROWN, TIMOTHY BENJAMIN (DDS)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:BENJAMIN
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 LONGFORD DR
Mailing Address - Street 2:SUITE #1
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174
Mailing Address - Country:US
Mailing Address - Phone:615-302-0281
Mailing Address - Fax:615-302-0287
Practice Address - Street 1:3012 LONGFORD DR
Practice Address - Street 2:SUITE #1
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174
Practice Address - Country:US
Practice Address - Phone:615-302-0281
Practice Address - Fax:615-302-0287
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7488122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist