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General NPI Number Information
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NPI Number | 1518706969
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Entity Type | Individual
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Provider Name | LEIGHA ANN BROWN DDS
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Gender | Female
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Dates
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Enumeration Date | 05/23/2024
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 508 N BIRCH ST
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City | KALKASKA
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State | MI
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Zip | 49646-8414
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Country | US
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Telephone | 231-242-3755
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Fax |
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Provider Business Mailing Address
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Address Line | 8636 UNDERWOOD RDG
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-1691
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Country | US
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Telephone | 231-883-4123
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901602182
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License Number State | MI
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