Provider Demographics
NPI:1013078039
Name:BROWNING, JEFFREY WAYNE (DDS)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:WAYNE
Last Name:BROWNING
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 1:1221 JOHNSON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-1389
Mailing Address - Country:US
Mailing Address - Phone:304-842-7591
Mailing Address - Fax:304-842-7615
Practice Address - Street 1:1221 JOHNSON AVE STE 200
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-1389
Practice Address - Country:US
Practice Address - Phone:304-842-7591
Practice Address - Fax:304-842-7615
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV31311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice