Individual
DR. JERRY LEE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
181 E 1ST AVE, COLVILLE, WA 99114-2801
(509) 684-3736
(509) 684-3407
Mailing address
181 E 1ST AVE, COLVILLE, WA 99114-2801
(509) 684-3736
(509) 684-3407
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00010567
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0210275
LABOR & INDUSTRIES ID #
WA
05
—
5050836
—
WA
Enumeration date
07/13/2006
Last updated
04/04/2013
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