Provider Demographics
NPI:1487069381
Name:STEVEN BROWN DDS A PROFESSIONAL CORP
Entity type:Organization
Organization Name:STEVEN BROWN DDS A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-543-1234
Mailing Address - Street 1:3480 TORRANCE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-5808
Mailing Address - Country:US
Mailing Address - Phone:310-543-1234
Mailing Address - Fax:310-543-8795
Practice Address - Street 1:3480 TORRANCE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5808
Practice Address - Country:US
Practice Address - Phone:310-543-1234
Practice Address - Fax:310-543-8795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty