Dr. Charles Robert Brown
Pediatric Dentist
912 S Ridgewood Ave Suite B
Daytona Beach
, Florida 32114-5349
Dr. Charles Robert Brown
Pediatric Dentist
912 S Ridgewood Ave Suite B
Daytona Beach
, Florida 32114-5349
(386) 761-5546
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About
Features
Specialties
- Pediatric Dentist
Languages spoken
- English
Location
First Address
- Dr. Charles Robert Brown
- 6211 Santa Monica Dr
- Port Orange, FL
- Zip : 32127-5964
- Phone : (386) 761-5546
Second Address
- Dr. Charles Robert Brown
- 912 S Ridgewood Ave Suite B
- Daytona Beach, FL
- Zip : 32114-5349
- Fax : (386) 239-0730
- Phone : (386) 258-6132
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0221X | Pediatric Dentist | 5643 | FL |
National Provider Identifier
| NPI | 1073613600 |
|---|---|
| Provider Name | Dr. Charles Robert Brown |
| First Address | Port Orange, FL 32127-5964 |
| Second Address | Daytona Beach, FL 32114-5349 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/09/2006 |
| Last Update Date | 09/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 5643 | DENTAL LICENSE NUMBER (01) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.