Provider Demographics
NPI:1962678276
Name:BROWN, RODRELL S (DDS)
Entity Type:Individual
Prefix:DR
First Name:RODRELL
Middle Name:S
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:8 UNDERHILL RD
Mailing Address - Street 2:APT 6
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-7097
Mailing Address - Country:US
Mailing Address - Phone:615-424-9104
Mailing Address - Fax:615-424-9104
Practice Address - Street 1:8 UNDERHILL RD
Practice Address - Street 2:APT 6
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-7097
Practice Address - Country:US
Practice Address - Phone:615-424-9104
Practice Address - Fax:615-424-9104
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2017-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO002030581223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry