Provider Demographics
NPI:1649211889
Name:BROWN, STEVEN KELLY (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:KELLY
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 1:2001 S DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-6063
Mailing Address - Country:US
Mailing Address - Phone:405-282-6440
Mailing Address - Fax:405-282-6785
Practice Address - Street 1:2001 S DIVISION ST
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-6063
Practice Address - Country:US
Practice Address - Phone:405-282-6440
Practice Address - Fax:405-282-6785
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK37671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice