Provider Demographics
NPI:1497069843
Name:TAYLOR, DARRON GRANT (DDS)
Entity Type:Individual
Prefix:
First Name:DARRON
Middle Name:GRANT
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 E 3300 S
Mailing Address - Street 2:SUITE #200
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-2749
Mailing Address - Country:US
Mailing Address - Phone:801-486-3887
Mailing Address - Fax:801-486-4170
Practice Address - Street 1:2560 E 3300 S
Practice Address - Street 2:SUITE #200
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84109-2749
Practice Address - Country:US
Practice Address - Phone:801-486-3887
Practice Address - Fax:801-486-4170
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT136117-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice