Provider Demographics
NPI:1043328669
Name:BROWN, RICHARD A (DMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:BROWN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:487 NORTHAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-4509
Mailing Address - Country:US
Mailing Address - Phone:570-288-4591
Mailing Address - Fax:570-714-7793
Practice Address - Street 1:487 NORTHAMPTON ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-4509
Practice Address - Country:US
Practice Address - Phone:570-288-4591
Practice Address - Fax:570-714-7793
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027347L1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry