Provider Demographics
NPI:1194725903
Name:DR JENNIE BROWN DDS PC
Entity type:Organization
Organization Name:DR JENNIE BROWN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIE
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-755-6700
Mailing Address - Street 1:1344 S CHAMBERS RD
Mailing Address - Street 2:#203
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-4096
Mailing Address - Country:US
Mailing Address - Phone:303-755-6700
Mailing Address - Fax:303-755-6703
Practice Address - Street 1:1344 S CHAMBERS RD
Practice Address - Street 2:#203
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-4096
Practice Address - Country:US
Practice Address - Phone:303-755-6700
Practice Address - Fax:303-755-6703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO76971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty