Provider Demographics
NPI:1659785889
Name:RICE, DANA
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6095 S FASHION BLVD STE 270
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-7387
Mailing Address - Country:US
Mailing Address - Phone:801-213-8351
Mailing Address - Fax:801-281-1952
Practice Address - Street 1:6095 S FASHION BLVD STE 270
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7387
Practice Address - Country:US
Practice Address - Phone:801-213-8351
Practice Address - Fax:801-281-1952
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7206117-1109207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology