Provider Demographics
NPI:1104025576
Name:BROWN, ARTHUR PORTER (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:PORTER
Last Name:BROWN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5065 WILLOW POINT PKWY
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-1754
Mailing Address - Country:US
Mailing Address - Phone:770-861-7969
Mailing Address - Fax:770-587-2362
Practice Address - Street 1:4463 TOWNE LAKE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-8230
Practice Address - Country:US
Practice Address - Phone:678-445-1105
Practice Address - Fax:678-445-8395
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA95301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice