Provider Demographics
NPI:1598596884
Name:BROWN, MADISON (DDS)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 N KNOLL RD STE 7
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1665
Mailing Address - Country:US
Mailing Address - Phone:415-383-0350
Mailing Address - Fax:
Practice Address - Street 1:7 N KNOLL RD STE 7B
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-1665
Practice Address - Country:US
Practice Address - Phone:415-383-0350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110404122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist