Provider Demographics
NPI:1184080335
Name:KATHERINE BROWN,DDS
Entity type:Organization
Organization Name:KATHERINE BROWN,DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-328-8544
Mailing Address - Street 1:625 MENLO AVE
Mailing Address - Street 2:STE 5
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4747
Mailing Address - Country:US
Mailing Address - Phone:650-328-8544
Mailing Address - Fax:
Practice Address - Street 1:625 MENLO AVE
Practice Address - Street 2:STE 5
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4747
Practice Address - Country:US
Practice Address - Phone:650-328-8544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KATHERINE BROWN DDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51465122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty