Provider Demographics
NPI:1245372101
Name:BROWN, CAROLINE FAITH (DDS)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:FAITH
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:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:CHICKAMAUGA
Mailing Address - State:GA
Mailing Address - Zip Code:30707-0369
Mailing Address - Country:US
Mailing Address - Phone:706-375-3621
Mailing Address - Fax:
Practice Address - Street 1:107 GORDON ST
Practice Address - Street 2:
Practice Address - City:CHICKAMAUGA
Practice Address - State:GA
Practice Address - Zip Code:30707-1454
Practice Address - Country:US
Practice Address - Phone:706-375-3621
Practice Address - Fax:706-375-8054
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2015-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY82721223G0001X
GADN0150751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice