Organization Name: | TIMOTHY S. BROWN, DDS, PA |
NPI Number: | 1760732804 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TIMOTHY S. BROWN (OWNER) |
Mailing Address: | 105 E Bridge St Redwood Falls |
State: | MN US |
Postal Code: | 562832607 |
Phone Number: | 5076373581 |
Fax Number: | 5076373580 |
NPI Enumeration Date: | 09/17/2012 |
NPI Last Update Date: | 09/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |