Provider Demographics
NPI:1093929994
Name:KEVIN E. BROWN, DMD, MS, PA
Entity Type:Organization
Organization Name:KEVIN E. BROWN, DMD, MS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:828-465-0187
Mailing Address - Street 1:3305 16TH AVE SE STE 12
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-9213
Mailing Address - Country:US
Mailing Address - Phone:828-465-0187
Mailing Address - Fax:828-465-5680
Practice Address - Street 1:3305 16TH AVE SE STE 12
Practice Address - Street 2:SUITE 301
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-9213
Practice Address - Country:US
Practice Address - Phone:828-465-0187
Practice Address - Fax:828-465-5680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC53801223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty