Provider Demographics
NPI:1700950797
Name:BROWN, LAURA E (DDS,MS,PA)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:E
Last Name:BROWN
Suffix:
Gender:F
Credentials:DDS,MS,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 W 151ST ST
Mailing Address - Street 2:#130
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5348
Mailing Address - Country:US
Mailing Address - Phone:913-764-8883
Mailing Address - Fax:913-764-9173
Practice Address - Street 1:153 W 151ST ST
Practice Address - Street 2:#130
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5348
Practice Address - Country:US
Practice Address - Phone:913-764-8883
Practice Address - Fax:913-764-9173
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS71211223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics