Provider Demographics
NPI:1336284710
Name:RAND, KATIE M (DMD)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:M
Last Name:RAND
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8847 MAPLE HILL CT
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-4855
Mailing Address - Country:US
Mailing Address - Phone:561-737-2248
Mailing Address - Fax:
Practice Address - Street 1:7730 BOYNTON BEACH BLVD STE 6
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-6155
Practice Address - Country:US
Practice Address - Phone:561-736-1900
Practice Address - Fax:561-736-1966
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN161081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice