Provider Demographics
NPI:1215006697
Name:BROWN, ANDREW ALOYSIUS (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:ALOYSIUS
Last Name:BROWN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-4666
Mailing Address - Country:US
Mailing Address - Phone:570-969-1838
Mailing Address - Fax:570-963-5790
Practice Address - Street 1:632 DAVIS ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-4666
Practice Address - Country:US
Practice Address - Phone:570-969-1838
Practice Address - Fax:570-963-5790
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025808L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice