Provider Demographics
NPI:1538220355
Name:BROWDER, MICHAEL HUGH (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HUGH
Last Name:BROWDER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1006
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-1006
Mailing Address - Country:US
Mailing Address - Phone:336-838-8851
Mailing Address - Fax:336-667-1197
Practice Address - Street 1:404 8TH ST
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-4130
Practice Address - Country:US
Practice Address - Phone:336-838-8851
Practice Address - Fax:336-667-1197
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC63071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8991092Medicaid