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General NPI Number Information
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NPI Number | 1326167354
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Entity Type | Individual
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Provider Name | JARED M BROWN DDS
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/01/2016
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Provider Practice Location Address
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Address Line | 11748 S 3600 W
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-5922
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Country | US
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Telephone | 801-938-3412
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Fax |
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Provider Business Mailing Address
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Address Line | 11748 S 3600 W
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-5922
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Country | US
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Telephone | 801-938-3412
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 6653
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License Number State | NE
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