Provider Demographics
NPI:1780739623
Name:BROWN, SHARON JAMES (RDH)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:JAMES
Last Name:BROWN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5519 JUNIPER BAY RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29527-4144
Mailing Address - Country:US
Mailing Address - Phone:843-397-3622
Mailing Address - Fax:
Practice Address - Street 1:803 2ND AVE N
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-3016
Practice Address - Country:US
Practice Address - Phone:843-249-1333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1244124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist