| Organization Name: | CLARK F. BROWN, JR. DDS, PA |
| NPI Number: | 1003839325 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CLARK FRANKLIN BROWN (PRESIDENT) |
| Mailing Address: | 2113 Sarno Rd Melbourne |
| State: | FL US |
| Postal Code: | 329353001 |
| Phone Number: | 3212599429 |
| Fax Number: | 3212595844 |
| NPI Enumeration Date: | 07/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DN8667 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |