Provider Demographics
NPI:1760446058
Name:BROWN, SCOTT HOLBROOK (DDS PC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:HOLBROOK
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3125
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-3125
Mailing Address - Country:US
Mailing Address - Phone:435-586-3885
Mailing Address - Fax:435-867-8934
Practice Address - Street 1:415 N MAIN STREET
Practice Address - Street 2:SUITE 301
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-2678
Practice Address - Country:US
Practice Address - Phone:435-586-3885
Practice Address - Fax:435-867-8934
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9114522199241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice