Provider Demographics
NPI:1437246402
Name:BROWN, LORI ANN KAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:ANN KAY
Last Name:BROWN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 W LIBERTY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-8724
Mailing Address - Country:US
Mailing Address - Phone:734-663-6777
Mailing Address - Fax:734-663-9820
Practice Address - Street 1:3100 W LIBERTY RD
Practice Address - Street 2:SUITE A
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-8724
Practice Address - Country:US
Practice Address - Phone:734-663-6777
Practice Address - Fax:734-663-9820
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI158121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice