Provider Demographics
NPI:1689289613
Name:BROWN, SYDNEY TAYLOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:TAYLOR
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 1:4455 SAM MITCHELL DR UNIT DENTAL
Mailing Address - Street 2:
Mailing Address - City:CHIPLEY
Mailing Address - State:FL
Mailing Address - Zip Code:32428-3501
Mailing Address - Country:US
Mailing Address - Phone:850-773-0221
Mailing Address - Fax:
Practice Address - Street 1:4455 SAM MITCHELL DR UNIT DENTAL
Practice Address - Street 2:
Practice Address - City:CHIPLEY
Practice Address - State:FL
Practice Address - Zip Code:32428-3501
Practice Address - Country:US
Practice Address - Phone:850-773-0221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN25238122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist