Provider Demographics
NPI:1316138670
Name:BROWN, JOHN WILLIAM III (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIAM
Last Name:BROWN
Suffix:III
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 1:10210 W JACK JOUETT RD
Mailing Address - Street 2:
Mailing Address - City:GORDONSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22942-6730
Mailing Address - Country:US
Mailing Address - Phone:540-832-3212
Mailing Address - Fax:208-545-8747
Practice Address - Street 1:1769 WORTH PARK
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-7441
Practice Address - Country:US
Practice Address - Phone:434-964-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010055981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice