Provider Demographics
NPI:1437559739
Name:KERRY J BROWN, DDS
Entity Type:Organization
Organization Name:KERRY J BROWN, DDS
Other - Org Name:BROWN ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER, DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-641-9490
Mailing Address - Street 1:2025 W LONG LAKE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-4100
Mailing Address - Country:US
Mailing Address - Phone:248-641-9490
Mailing Address - Fax:248-641-0785
Practice Address - Street 1:2025 W LONG LAKE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-4100
Practice Address - Country:US
Practice Address - Phone:248-641-9490
Practice Address - Fax:248-641-0785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901013421261QD0000X
MI2901021106261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental