Provider Demographics
NPI:1114949377
Name:ALESIA D. BROWN, D.M.D. P.C.
Entity Type:Organization
Organization Name:ALESIA D. BROWN, D.M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALESIA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:812-874-2235
Mailing Address - Street 1:16 N CALE SREET
Mailing Address - Street 2:PO BOX 370
Mailing Address - City:POSEYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47633
Mailing Address - Country:US
Mailing Address - Phone:812-874-2235
Mailing Address - Fax:812-874-2247
Practice Address - Street 1:16 N CALE STREET
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:812-874-3347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010219A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200374620Medicaid