Provider Demographics
NPI:1346070737
Name:BROWN, KAYLA ALEXA (DDS)
Entity type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:ALEXA
Last Name:BROWN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4493 BROWNSVILLE RD APT 3309
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-8118
Mailing Address - Country:US
Mailing Address - Phone:973-666-1644
Mailing Address - Fax:
Practice Address - Street 1:5140 JIMMY LEE SMITH PKWY STE 101
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-2746
Practice Address - Country:US
Practice Address - Phone:770-439-1038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1235431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice