Organization · NPI-2

Justin Brown DDS LLC

Dentist · Peru, IN

NPI number1851573539
StatusActive
Last updated in NPPESJul 26, 2016

Details

NPI
1851573539
Entity type
Organization (NPI-2)
Legal business name
Justin Brown DDS LLC
Organization subpart
No
Enumeration date
Dec 4, 2007
Last updated
Jul 26, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist10988INYes

Other names

  • Peru Dental Care (Doing Business As)

Practice location

5 Logan St
Peru, IN 46970-1642

Phone 765-473-9336 · Fax 765-460-5743

Mailing address

5 Logan St
Peru, IN 46970-1642

Phone 765-473-9336 · Fax 765-460-5743

Authorized official

Justin D Brown
Owner
7654739336

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