Provider Demographics
NPI:1952526063
Name:BROWN, CHARLES E III (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:E
Last Name:BROWN
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:TREY
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2755 MATLOCK ROAD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015
Mailing Address - Country:US
Mailing Address - Phone:817-261-8220
Mailing Address - Fax:817-274-8220
Practice Address - Street 1:2755 MATLOCK ROAD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015
Practice Address - Country:US
Practice Address - Phone:817-261-8220
Practice Address - Fax:817-274-8220
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA51711223E0200X
TX259331223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics