Organization
J. RENA OWSLEY-BROWN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J. RENA OWSLEY-BROWN DMD (DENTIST/OWNER)
(770) 461-5500
Entity
Organization
Contact information
Practice address
1275 HIGHWAY 54 W, SUITE 204, FAYETTEVILLE, GA 30214-4549
(770) 461-5500
(770) 461-1033
Mailing address
1275 HIGHWAY 54 W, SUITE 204, FAYETTEVILLE, GA 30214-4549
(770) 461-5500
(770) 461-1033
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DNO12893
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110289
DORAL
GA
Enumeration date
04/01/2008
Last updated
04/01/2008
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