Brown, Bradley Jesse

Brown, Bradley Jesse is an sole proprietor health care provider with primary practice located at 101 5Th St , Ellwood City PA 16117-2303. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / Dentist is his primary health care specialty. Brown, Bradley Jesse can be contacted via phone (724) 752-1506.

Contact Information

Primary practice address
101 5Th St Ellwood City PA 16117-2303
Phone: (724) 752-1506
Fax: (724) 752-2108
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DS025807L Pennsylvania
Dental Providers / Dentist 122300000X DS025807L Pennsylvania

Profile Details

NPI number 1174597561
LBN Legal business name Brown, Bradley Jesse
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 14th, 2006
Last updated Aug 5th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174597561 NPPES
Pennsylvania Other BR509853 UNITED CONCORDIA PROVIDER

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