Provider Demographics
NPI:1710244439
Name:BROWN MCDONALD, RACHEL LYNN (DDS)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNN
Last Name:BROWN MCDONALD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3327 W CAPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-1334
Mailing Address - Country:US
Mailing Address - Phone:308-382-1890
Mailing Address - Fax:
Practice Address - Street 1:3327 W CAPITAL AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-1334
Practice Address - Country:US
Practice Address - Phone:308-382-1890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7101122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist