Provider Demographics
NPI:1407869381
Name:BROWN, LAWRENCE R (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:R
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:KIM
Other - Middle Name:R
Other - Last Name:KUPPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:8191 BECKETT PARK DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-9198
Mailing Address - Country:US
Mailing Address - Phone:513-860-3660
Mailing Address - Fax:513-870-4932
Practice Address - Street 1:8191 BECKETT PARK DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-9198
Practice Address - Country:US
Practice Address - Phone:513-860-3660
Practice Address - Fax:513-870-4932
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH160421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice