Provider Demographics
NPI:1851848295
Name:BROWN, KEVIN (DDS)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
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 1:2740 SW 97TH AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2681
Mailing Address - Country:US
Mailing Address - Phone:305-485-4000
Mailing Address - Fax:305-485-4455
Practice Address - Street 1:2740 SW 97TH AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2681
Practice Address - Country:US
Practice Address - Phone:305-485-4000
Practice Address - Fax:305-485-4455
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16672122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist