Provider Demographics
NPI:1306166780
Name:BROWN, LEONARD L JR (DDS)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:L
Last Name:BROWN
Suffix:JR
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 1:620 OWL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-6251
Mailing Address - Country:US
Mailing Address - Phone:248-930-9291
Mailing Address - Fax:
Practice Address - Street 1:620 OWL CREEK DR
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-6251
Practice Address - Country:US
Practice Address - Phone:248-930-9291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010133351223X0400X
GADN1236531223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics