Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | HD104663 | CO |
NPI | 1376604306 |
---|---|
Provider Name | Dr. Bregetta Trinace Brown |
First Address | Denver, CO 80239-4457 |
Second Address | Denver, CO 80236-3101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |