Provider Demographics
NPI:1073794640
Name:BROWN, ALESIA D (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALESIA
Middle Name:D
Last Name:BROWN
Suffix:
Gender:F
Credentials:DMD
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 370
Mailing Address - Street 2:
Mailing Address - City:POSEYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47633-0370
Mailing Address - Country:US
Mailing Address - Phone:812-874-2235
Mailing Address - Fax:812-874-2247
Practice Address - Street 1:16 N CALE ST
Practice Address - Street 2:
Practice Address - City:POSEYVILLE
Practice Address - State:IN
Practice Address - Zip Code:47633
Practice Address - Country:US
Practice Address - Phone:812-874-2235
Practice Address - Fax:812-874-2247
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010219A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist