MEDICARE: DR. BRYCE J TAYLOR D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	D11373	OR

General Provider Information

NPI Number	:	1699969162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYCE J TAYLOR D.D.S

Provider Business Mailing Address
First Line	:	3534 LONE PINE RD
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97504-5637
Country	:	US
Telephone Number	:	541-200-0321
Fax Number	:

Provider Business Practice Location Address
First Line	:	3534 LONE PINE RD
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97504-5637
Country	:	US
Telephone Number	:	541-200-0321
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2007
Last Update Date	:	02/14/2025

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