Provider Demographics
NPI:1447788898
Name:BROWN, DAVID KYLE (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:KYLE
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 1:2211 DOWNS AVE
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-5309
Mailing Address - Country:US
Mailing Address - Phone:580-256-8668
Mailing Address - Fax:580-256-8670
Practice Address - Street 1:2211 DOWNS AVE
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-5309
Practice Address - Country:US
Practice Address - Phone:580-256-8668
Practice Address - Fax:580-256-8670
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6935122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist