Provider Demographics
NPI:1386809788
Name:BROWN, ALFRED R (DDS)
Entity type:Individual
Prefix:
First Name:ALFRED
Middle Name:R
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 1:2682 LAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38114-4351
Mailing Address - Country:US
Mailing Address - Phone:901-454-1200
Mailing Address - Fax:901-454-0731
Practice Address - Street 1:2682 LAMAR AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38114-4351
Practice Address - Country:US
Practice Address - Phone:901-454-1200
Practice Address - Fax:901-454-0731
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2405122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist