Provider Demographics
NPI:1962842971
Name:BROWN, ROBERT EARLY III (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EARLY
Last Name:BROWN
Suffix:III
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:PO BOX 1357
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-1357
Mailing Address - Country:US
Mailing Address - Phone:239-278-3600
Mailing Address - Fax:239-278-3857
Practice Address - Street 1:8359 STRINGFELLOW RD
Practice Address - Street 2:
Practice Address - City:ST JAMES CITY
Practice Address - State:FL
Practice Address - Zip Code:33956-2910
Practice Address - Country:US
Practice Address - Phone:239-344-2354
Practice Address - Fax:239-283-9276
Is Sole Proprietor?:No
Enumeration Date:2013-07-05
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN201801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009080600Medicaid