Provider Demographics
NPI:1174624381
Name:BROWDER, THERESA B (DDS)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:B
Last Name:BROWDER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37321-1326
Mailing Address - Country:US
Mailing Address - Phone:423-775-8280
Mailing Address - Fax:423-570-8815
Practice Address - Street 1:155 MAIN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-1326
Practice Address - Country:US
Practice Address - Phone:423-775-8280
Practice Address - Fax:423-570-8815
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS43431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice