Provider Demographics
NPI:1871064709
Name:BROWN, EZRA JARED (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:EZRA
Middle Name:JARED
Last Name:BROWN
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:96 OTTOWA RD S
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1246
Mailing Address - Country:US
Mailing Address - Phone:908-692-5586
Mailing Address - Fax:
Practice Address - Street 1:33 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1470
Practice Address - Country:US
Practice Address - Phone:732-577-0075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1026420001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics