Provider Demographics
NPI:1518706969
Name:BROWN, LEIGHA ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:LEIGHA
Middle Name:ANN
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 1:8636 UNDERWOOD RDG
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-1691
Mailing Address - Country:US
Mailing Address - Phone:231-883-4123
Mailing Address - Fax:
Practice Address - Street 1:508 N BIRCH ST
Practice Address - Street 2:
Practice Address - City:KALKASKA
Practice Address - State:MI
Practice Address - Zip Code:49646-8414
Practice Address - Country:US
Practice Address - Phone:231-242-3755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901602182122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist