Provider Demographics
NPI:1740599158
Name:BROWN, UI SON
Entity type:Individual
Prefix:
First Name:UI SON
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 E OSBORN RD
Mailing Address - Street 2:# 135
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5202
Mailing Address - Country:US
Mailing Address - Phone:303-817-9247
Mailing Address - Fax:
Practice Address - Street 1:1100 E OSBORN RD
Practice Address - Street 2:# 135
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5202
Practice Address - Country:US
Practice Address - Phone:303-817-9247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-03
Last Update Date:2010-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant