Provider Demographics
NPI:1992716369
Name:BROWN, STEPHEN M III (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:BROWN
Suffix:III
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 1:136 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-5725
Mailing Address - Country:US
Mailing Address - Phone:318-357-0130
Mailing Address - Fax:318-357-0800
Practice Address - Street 1:136 E 5TH ST
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-5725
Practice Address - Country:US
Practice Address - Phone:318-357-0130
Practice Address - Fax:318-357-0800
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA26761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice