Provider Demographics
NPI:1780612705
Name:BROWER, KATHLEEN HERB (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:HERB
Last Name:BROWER
Suffix:
Gender:F
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 ROUTE 202
Mailing Address - Street 2:GEORGETOWN CROSSINGS, STE 210
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-6601
Mailing Address - Country:US
Mailing Address - Phone:215-794-7976
Mailing Address - Fax:215-794-7976
Practice Address - Street 1:3655 ROUTE 202
Practice Address - Street 2:GEORGETOWN CROSSINGS, STE 210
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-6601
Practice Address - Country:US
Practice Address - Phone:215-794-7976
Practice Address - Fax:215-794-7976
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028192L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001958739001Medicaid
PA013901A9Medicare ID - Type Unspecified
PA001958739001Medicaid