Provider Demographics
NPI:1558057034
Name:PATRICK KELLY BROWN, DDS, PLLC
Entity Type:Organization
Organization Name:PATRICK KELLY BROWN, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-619-0010
Mailing Address - Street 1:427 ANCHOR WAY
Mailing Address - Street 2:
Mailing Address - City:KURE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28449-4803
Mailing Address - Country:US
Mailing Address - Phone:919-619-0010
Mailing Address - Fax:
Practice Address - Street 1:1300 BRIDGE BARRIER RD
Practice Address - Street 2:
Practice Address - City:CAROLINA BEACH
Practice Address - State:NC
Practice Address - Zip Code:28428-3938
Practice Address - Country:US
Practice Address - Phone:919-619-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental