Provider Demographics
NPI:1699824409
Name:BRAND, ADAM JAY (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JAY
Last Name:BRAND
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10425 TIERRASANTA BLVD
Mailing Address - Street 2:SUITE #205
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-2618
Mailing Address - Country:US
Mailing Address - Phone:858-560-6374
Mailing Address - Fax:
Practice Address - Street 1:10425 TIERRASANTA BLVD
Practice Address - Street 2:SUITE #205
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92124-2618
Practice Address - Country:US
Practice Address - Phone:858-560-6374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA462461223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics