Provider Demographics
NPI:1447688643
Name:BROWN, DAVID ALAN (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:BROWN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 W BAY DR
Mailing Address - Street 2:SUITE #1
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3024
Mailing Address - Country:US
Mailing Address - Phone:727-586-1732
Mailing Address - Fax:727-586-5262
Practice Address - Street 1:1940 W BAY DR
Practice Address - Street 2:SUITE #1
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3024
Practice Address - Country:US
Practice Address - Phone:727-586-1732
Practice Address - Fax:727-586-5262
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN99951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice