Provider Demographics
NPI:1962729046
Name:BROWN, BENJAMAN ROY (DDS)
Entity type:Individual
Prefix:
First Name:BENJAMAN
Middle Name:ROY
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 1:123 W FRANCIS AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6348
Mailing Address - Country:US
Mailing Address - Phone:509-928-8800
Mailing Address - Fax:509-321-0154
Practice Address - Street 1:123 W FRANCIS AVE STE 102
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6348
Practice Address - Country:US
Practice Address - Phone:509-928-8800
Practice Address - Fax:509-321-0154
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA611503631223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery