Provider Demographics
NPI:1013420553
Name:KEVIN BROWN DMD, LLC
Entity Type:Organization
Organization Name:KEVIN BROWN DMD, LLC
Other - Org Name:ALPINE KIDS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSD
Authorized Official - Phone:801-828-0483
Mailing Address - Street 1:1468 N 2350 W
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-5536
Mailing Address - Country:US
Mailing Address - Phone:801-828-0483
Mailing Address - Fax:
Practice Address - Street 1:1030 S 1100 W
Practice Address - Street 2:SUITE B
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043
Practice Address - Country:US
Practice Address - Phone:801-828-0483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty