Provider Demographics
NPI:1952478265
Name:BROWN, PAMELA SUSAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:SUSAN
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 1:1575 BOSTON POST RD BLDG B SUITE B
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2319
Mailing Address - Country:US
Mailing Address - Phone:203-453-9601
Mailing Address - Fax:203-562-8519
Practice Address - Street 1:1575 BOSTON POST RD BLDG B SUITE B
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2319
Practice Address - Country:US
Practice Address - Phone:203-453-9601
Practice Address - Fax:203-562-8519
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT49181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice