Healthcare Provider Details

I. General information

NPI: 1669099909
Provider Name (Legal Business Name): BRIAN ROSELL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2020
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 E SAINT GEORGE BLVD STE 201
ST GEORGE UT
84770-7106
US

IV. Provider business mailing address

335 E SAINT GEORGE BLVD STE 201
ST GEORGE UT
84770-7106
US

V. Phone/Fax

Practice location:
  • Phone: 801-960-0692
  • Fax:
Mailing address:
  • Phone: 801-960-0692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14013440-9926
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: