Provider Demographics
NPI:1699763367
Name:BROWN, LINDSAY MICHAEL (DDS)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:MICHAEL
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 1:3250 10TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-1507
Mailing Address - Country:US
Mailing Address - Phone:319-377-4805
Mailing Address - Fax:
Practice Address - Street 1:3250 10TH AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-1507
Practice Address - Country:US
Practice Address - Phone:319-377-4805
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA66631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice