Individual
DR. KIMBERLY BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
395 N JEFF DAVIS DR STE A, FAYETTEVILLE, GA 30214-1672
(770) 460-0870
Mailing address
102 HAMMOCK BAY DR, FAYETTEVILLE, GA 30215-7152
(601) 572-6808
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3174
MS
1223G0001X
General Practice Dentistry
Primary
DN014931
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660404
—
MS
Enumeration date
06/15/2006
Last updated
06/16/2022
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