MEDICARE: KEVIN F BROWN DMD

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	16-0001004	VT

General Provider Information

NPI Number	:	1558428243
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEVIN F BROWN DMD

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

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	:

Authorized Official
Title or Position	:	OWNER
Name	:	KEVIN BROWN
Credential	:
Telephone Number	:	802-868-3335

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	07/17/2008

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