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Organization

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Organization

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Organization subpart
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Provider details

NPI number
Authorized official
DR. GLENN A BROWN DMD (PRESIDENT)
(610) 734-0666
Entity
Organization

Contact information

Practice address
6776 MARKET ST, UPPER DARBY, PA 19082-2432
(610) 734-0115
Mailing address
6776 MARKET ST, UPPER DARBY, PA 19082-2432
(610) 734-0115

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS 023270 L
PA
1223E0200X
Endodontics
DS 025089 L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009098000001
—
PA
01
—
401786
UNITED CONCORDIA
PA
Enumeration date
02/13/2006
Last updated
09/11/2025
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