Individual
DR. JACK BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
48 E KINGSBRIDGE RD FRNT 1, BRONX, NY 10468-7514
(718) 933-9603
Mailing address
2969 HEWLETT AVE, MERRICK, NY 11566-5312
(516) 643-0424
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
054002
NY
Other
Enumeration date
08/14/2008
Last updated
05/07/2020
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