Individual
GABRIEL BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
101 ELM AVE SE, ROANOKE, VA 24013-2222
(540) 224-4380
Mailing address
5612 GREEN MEADOW RD, ROANOKE, VA 24018-3228
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401-410219
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7800967
—
VA
Enumeration date
04/10/2006
Last updated
04/25/2008
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