# DR. JACK I. BROWN, DDS, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033121405
- **Authorized official:** TAMMY R. ALSOBROOK RDA (OFFICE MANAGER)
- **Authorized official phone:** (310) 278-9624

## Contact information

- **Practice address:** 416 N BEDFORD DR, SUITE 103, BEVERLY HILLS, CA 90210-4322
- **Practice address phone:** (310) 278-9624
- **Practice address fax:** (310) 278-0695
- **Mailing address:** 416 N BEDFORD DR, SUITE 103, BEVERLY HILLS, CA 90210-4322
- **Mailing address phone:** (310) 278-9624
- **Mailing address fax:** (310) 278-0695

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 18295 | CA | Yes |

## Other

- **Enumeration date:** 08/13/2006
- **Last updated:** 08/22/2020