Provider Demographics
NPI:1316281132
Name:BROWN, STEPHEN JAMES (DMD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JAMES
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 1:432 W. BUTTERFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:CHINO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86323
Mailing Address - Country:US
Mailing Address - Phone:702-281-1010
Mailing Address - Fax:
Practice Address - Street 1:432 BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:CHINO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86323-5613
Practice Address - Country:US
Practice Address - Phone:702-281-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-16
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8586122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist