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1982448759
TAYLOR V PETTIT
LOGAN, UT
NPI
1982448759
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: UT 14038757-9923)
Enumeration Date
2024-06-25
Last Update Date
2024-07-02
Business Address
TAYLOR V PETTIT DDS
167 E 200 N STE 3
LOGAN, UT 84321-4049
Phone number: 435-363-3584
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Mailing Address
TAYLOR V PETTIT DDS
197 EVERGREEN DR
IDAHO FALLS, ID 83401-2907
Phone number: 208-971-2125
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