Provider Demographics
NPI:1205815867
Name:BROWN, ORVILLE E (DDS)
Entity Type:Individual
Prefix:
First Name:ORVILLE
Middle Name:E
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7032 E LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-2638
Mailing Address - Country:US
Mailing Address - Phone:316-687-0100
Mailing Address - Fax:316-686-0181
Practice Address - Street 1:7032 E LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-2638
Practice Address - Country:US
Practice Address - Phone:316-687-0100
Practice Address - Fax:316-686-0181
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS43141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice