NPI 1114013604 · live from the CMS NPI Registry
Theodore A Brown, D.D.S.
Dentist, General Practice in Mohall, ND. National Provider Identifier 1114013604, active.
NPI record
| NPI | 1114013604 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 106 3rd Ave Se, Mohall, ND 58761 |
| Practice phone | 701-756-6655 |
| Mailing address | P.O. Box 188, Mohall, ND 58761 |
| Enumerated | October 4, 2006 |
| Last updated | July 9, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | 1760 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.