Provider Demographics
NPI:1093810954
Name:DAINES, HOWARD RAINEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:RAINEY
Last Name:DAINES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 W 200 S
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-2506
Mailing Address - Country:US
Mailing Address - Phone:435-734-2394
Mailing Address - Fax:435-734-0117
Practice Address - Street 1:104 W 200 S
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-2506
Practice Address - Country:US
Practice Address - Phone:435-734-2394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT47459891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice