MEDICARE: KEVIN BROWN D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry		VT

General Provider Information

NPI Number	:	1245254770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN BROWN D.M.D.

Provider Business Mailing Address
First Line	:	2 SPRING ST
Second Line	:
City	:	SWANTON
State	:	VT
Zip	:	05488-1329
Country	:	US
Telephone Number	:	802-868-3335
Fax Number	:	802-868-3931

Provider Business Practice Location Address
First Line	:	2 SPRING ST
Second Line	:
City	:	SWANTON
State	:	VT
Zip	:	05488-1329
Country	:	US
Telephone Number	:	802-868-3335
Fax Number	:	802-868-3931

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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