Provider Demographics
NPI:1306050562
Name:BROWN, EDWARD CLAUDE (DDS)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:CLAUDE
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5003 ASHFORD DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-2793
Mailing Address - Country:US
Mailing Address - Phone:301-627-8314
Mailing Address - Fax:301-627-6699
Practice Address - Street 1:9400 LIVINGSTON RD
Practice Address - Street 2:SUITE #430
Practice Address - City:FT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4958
Practice Address - Country:US
Practice Address - Phone:301-248-0144
Practice Address - Fax:301-248-0796
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD86971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice