Provider Demographics
NPI:1750932273
Name:MICHAEL R. BROWN DDS MS
Entity type:Organization
Organization Name:MICHAEL R. BROWN DDS MS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RORY
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:435-634-9933
Mailing Address - Street 1:1240 E 100 S STE 120
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-3079
Mailing Address - Country:US
Mailing Address - Phone:435-634-9933
Mailing Address - Fax:435-634-9930
Practice Address - Street 1:1240 E 100 S STE 120
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-3079
Practice Address - Country:US
Practice Address - Phone:435-634-9933
Practice Address - Fax:435-634-9930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty