Provider Demographics
NPI:1053582742
Name:BROWN-JOSEPH, BELINDA (DMD,MS)
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:
Last Name:BROWN-JOSEPH
Suffix:
Gender:F
Credentials:DMD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 WEST EVERGREEN AVENUE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118
Mailing Address - Country:US
Mailing Address - Phone:215-242-9411
Mailing Address - Fax:215-242-3454
Practice Address - Street 1:40 WEST EVERGREEN AVENUE
Practice Address - Street 2:SUITE 111
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118
Practice Address - Country:US
Practice Address - Phone:215-242-9411
Practice Address - Fax:215-242-3454
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030579-L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics