Provider Demographics
NPI:1598856510
Name:BROWN, MARY CHRISTINE (DMD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:CHRISTINE
Last Name:BROWN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 SW MULTNOMAH BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-3999
Mailing Address - Country:US
Mailing Address - Phone:503-246-7700
Mailing Address - Fax:503-296-5339
Practice Address - Street 1:2350 SW MULTNOMAH BLVD STE B
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-3999
Practice Address - Country:US
Practice Address - Phone:503-246-7700
Practice Address - Fax:503-296-5339
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD79571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice