Individual
CHARLES BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9682 US HIGHWAY 19, PORT RICHEY, FL 34668-4642
(727) 842-2422
Mailing address
1770 N WICKHAM RD, MELBOURNE, FL 32935-8122
(321) 253-9792
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN11570
FL
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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