Organization
JUSTIN BROWN DDS LLC
Active
Other names
Peru Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN D BROWN DDS (OWNER)
(765) 473-9336
Entity
Organization
Contact information
Practice address
5 LOGAN ST, PERU, IN 46970-1642
(765) 473-9336
(765) 460-5743
Mailing address
5 LOGAN ST, PERU, IN 46970-1642
(765) 473-9336
(765) 460-5743
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10988
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200864790A
—
IN
Enumeration date
12/04/2007
Last updated
07/26/2016
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