Provider Demographics
NPI:1003104480
Name:BROWN, RAND (DDS)
Entity type:Individual
Prefix:DR
First Name:RAND
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 E 9400 S
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093-2957
Mailing Address - Country:US
Mailing Address - Phone:801-571-1995
Mailing Address - Fax:801-491-0393
Practice Address - Street 1:1434 E 9400 S
Practice Address - Street 2:SUITE 204
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84093-2957
Practice Address - Country:US
Practice Address - Phone:801-571-1995
Practice Address - Fax:801-491-0393
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1356221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics