Provider Demographics
NPI:1962917336
Name:WILLIAM W BROWN, JR. DDS PA
Entity type:Organization
Organization Name:WILLIAM W BROWN, JR. DDS PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:864-322-5051
Mailing Address - Street 1:1220 N PLEASANTBURG DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:39607
Mailing Address - Country:US
Mailing Address - Phone:864-322-5051
Mailing Address - Fax:864-322-5281
Practice Address - Street 1:1220 N PLEASANTBURG DRIVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:39607
Practice Address - Country:US
Practice Address - Phone:864-322-5051
Practice Address - Fax:864-322-5281
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLIAM W. BROWN, JR. DDS PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-07
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC29751223G0001X
SCSC86021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty