MEDICARE: DR. BRUCE A. PYPER DMD

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	1223G0001X	General Practice Dentistry	295385-9921	UT

General Provider Information

NPI Number	:	1609037779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE A. PYPER DMD

Provider Business Mailing Address
First Line	:	999 E MURRAY HOLLADAY RD STE 205
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-5093
Country	:	US
Telephone Number	:	801-277-8233
Fax Number	:

Provider Business Practice Location Address
First Line	:	999 E MURRAY HOLLADAY RD STE 205
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-5093
Country	:	US
Telephone Number	:	801-277-8233
Fax Number	:

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

Provider Enumeration Date	:	06/21/2008
Last Update Date	:	07/31/2013

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