Brown, Charles Robert

Brown, Charles Robert is an sole proprietor health care provider with primary practice located at 912 S Ridgewood Ave Suite B, Daytona Beach FL 32114-5349. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Brown, Charles Robert can be contacted via phone (386) 258-6132.

Contact Information

Primary practice address
912 S Ridgewood Ave Suite B Daytona Beach FL 32114-5349
Phone: (386) 258-6132
Fax: (386) 239-0730
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 5643 Florida

Profile Details

NPI number 1073613600
LBN Legal business name Brown, Charles Robert
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 24th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073613600 NPPES
Florida Other 5643 DENTAL LICENSE NUMBER

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