Provider Demographics
NPI:1962834010
Name:BROWN, EMILY LOUISE (DMD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:LOUISE
Last Name:BROWN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8250 WATTERSON TRL
Mailing Address - Street 2:#1
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-1196
Mailing Address - Country:US
Mailing Address - Phone:502-499-0234
Mailing Address - Fax:502-499-0233
Practice Address - Street 1:8250 WATTERSON TRL
Practice Address - Street 2:#1
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-1196
Practice Address - Country:US
Practice Address - Phone:502-499-0234
Practice Address - Fax:502-499-0233
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9290122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist