# BRADLEY J. BROWN D.D.S.,P.C.

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

## Provider details

- **NPI number:** 1053385625
- **Authorized official:** DR. BRADLEY JESSE BROWN D.D.S. (PRES OF CORP/OWNER DENTIST)
- **Authorized official phone:** (724) 752-1506

## Contact information

- **Practice address:** 101 5TH ST, ELLWOOD CITY, PA 16117-2303
- **Practice address phone:** (724) 752-1506
- **Practice address fax:** (724) 752-2018
- **Mailing address:** 101 5TH ST, ELLWOOD CITY, PA 16117-2303
- **Mailing address phone:** (724) 752-1506
- **Mailing address fax:** (724) 752-2018

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS025807L | PA | Yes |

## Other

- **Enumeration date:** 02/13/2006
- **Last updated:** 06/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | BR509853 | UNITED CONCORDIA PROVIDER | PA |