Provider Demographics
NPI:1285142067
Name:BROWN-WALB, JOY (RDH PHDH)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:BROWN-WALB
Suffix:
Gender:F
Credentials:RDH PHDH
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17 WELLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1827
Mailing Address - Country:US
Mailing Address - Phone:610-451-8940
Mailing Address - Fax:717-354-0284
Practice Address - Street 1:584 SPRINGVILLE RD
Practice Address - Street 2:
Practice Address - City:NEW HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:17557-9564
Practice Address - Country:US
Practice Address - Phone:717-354-4711
Practice Address - Fax:717-354-0284
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH013396L124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist