# JUSTIN BROWN DDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Peru Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851573539
- **Authorized official:** DR. JUSTIN D BROWN DDS (OWNER)
- **Authorized official phone:** (765) 473-9336

## Contact information

- **Practice address:** 5 LOGAN ST, PERU, IN 46970-1642
- **Practice address phone:** (765) 473-9336
- **Practice address fax:** (765) 460-5743
- **Mailing address:** 5 LOGAN ST, PERU, IN 46970-1642
- **Mailing address phone:** (765) 473-9336
- **Mailing address fax:** (765) 460-5743

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 10988 | IN | Yes |

## Other

- **Enumeration date:** 12/04/2007
- **Last updated:** 07/26/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200864790A | — | IN |