Provider Demographics
NPI:1053683979
Name:BROWN, STEPHANIE LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LYNN
Last Name:BROWN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:964 NC HIGHWAY 42 W
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-7434
Mailing Address - Country:US
Mailing Address - Phone:919-451-2364
Mailing Address - Fax:
Practice Address - Street 1:964 NC HIGHWAY 42 W
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-7434
Practice Address - Country:US
Practice Address - Phone:919-553-7695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC92141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice