| Kennell P. Brown, Jr. Dds, Apdc | |
|
306 N Lewis St Suite 2 New Iberia LA 70563-2843 | |
| (337) 369-7654 | |
| (337) 367-3439 |
| Full Name | Kennell P. Brown, Jr. Dds, Apdc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 306 N Lewis St, New Iberia, Louisiana |
| Authorized Official Name and Position | Kennell P Brown (PRESIDENT) |
| Authorized Official Contact | 3373697654 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kennell P. Brown, Jr. Dds, Apdc 306 N Lewis St Suite 2 New Iberia LA 70563-2843 Ph: (337) 369-7654 | Kennell P. Brown, Jr. Dds, Apdc 306 N Lewis St Suite 2 New Iberia LA 70563-2843 Ph: (337) 369-7654 |
| NPI Number | 1558527689 |
|---|---|
| Provider Enumeration Date | 07/29/2008 |
| Last Update Date | 07/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558527689 | NPI | - | NPPES |
| 1835277 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 3527 (Louisiana) | Primary |
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