Individual
DR. RANDY CHARLES BRAITHWAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
121 S 1370 E, LINDON, UT 84042-2201
(801) 785-9776
Mailing address
121 S 1370 E, LINDON, UT 84042-2201
(801) 785-9776
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5070492-9922
UT
Other
Enumeration date
05/26/2006
Last updated
07/11/2008
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