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NPI 1962600478

NPI 1962600478 : BRANDON H TAYLER D.D.S : AMERICAN FORK, UT

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General NPI Number Information
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    NPI Number           |    1962600478
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    Entity Type          |    Individual 
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    Provider Name        |    BRANDON H TAYLER D.D.S
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/05/2007
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    Last Update Date     |    02/19/2019
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Provider Practice Location Address
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    Address Line         |    101 NORTH WEST STATE RD STE 108 
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    City                 |    AMERICAN FORK
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    State                |    UT
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    Zip                  |    84003
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    Country              |    US
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    Telephone            |    801-768-9471
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    Fax                  |    801-768-1287
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Provider Business Mailing Address
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    Address Line         |    101 NORTH WEST STATE RD. STE 108 
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    City                 |    AMERICAN FORK
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    State                |    UT
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    Zip                  |    84003
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    Country              |    US
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    Telephone            |    801-768-9471
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    Fax                  |    801-768-1287
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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        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    6638431-9922
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    License Number State |    UT
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