Provider Demographics
NPI:1710873336
Name:BROWN, CALVIN ARTHUR (DDS)
Entity type:Individual
Prefix:
First Name:CALVIN
Middle Name:ARTHUR
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3069 LOBELLA DR
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-0500
Mailing Address - Country:US
Mailing Address - Phone:435-592-0438
Mailing Address - Fax:
Practice Address - Street 1:3069 LOBELLA DR
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-0500
Practice Address - Country:US
Practice Address - Phone:435-592-0438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14225317-9926122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist