Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 3914 | AL |
N | 1223D0001X | Dental Public Health | 3914 | AL |
N | 1223G0001X | General Practice | 3914 | AL |
N | 213EG0000X | General Practice | 3914 | AL |
NPI | 1699925735 |
---|---|
Provider Name | Dr. Janniece Brown |
First Address | Montgomery, AL 36117-5521 |
Second Address | Montgomery, AL 36117-5521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2008 |
Last Update Date | 25/09/2008 |