Individual
DR. BRADLEY JESSE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
101 5TH ST, ELLWOOD CITY, PA 16117-2303
(724) 752-1506
(724) 752-2108
Mailing address
101 5TH ST, ELLWOOD CITY, PA 16117-2303
(724) 752-1506
(724) 752-2108
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS025807L
PA
1223G0001X
General Practice Dentistry
DS025807L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BR509853
UNITED CONCORDIA PROVIDER
PA
Enumeration date
02/14/2006
Last updated
08/05/2020
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