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Individual

DR. KEITH A BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
16 PLAZA DRIVE, LUCEDALE, MS 39452
(601) 947-1219
(601) 947-9461
Mailing address
PO BOX 6, LUCEDALE, MS 39452-0006
(601) 947-1219
(601) 947-9461

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2663 92D
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00660013
MS
Enumeration date
04/26/2007
Last updated
07/09/2007
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