Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 7061 | MD |
NPI | 1003961186 |
---|---|
Provider Name | Dr. Hyacinth Marie Brown |
First Address | Cheverly, MD 20785-1451 |
Second Address | Cheverly, MD 20785-1451 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 08/07/2007 |