Provider Demographics
NPI:1609037779
Name:PYPER, BRUCE A (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:A
Last Name:PYPER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 E MURRAY HOLLADAY RD STE 205
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-5093
Mailing Address - Country:US
Mailing Address - Phone:801-277-8233
Mailing Address - Fax:
Practice Address - Street 1:999 E MURRAY HOLLADAY RD STE 205
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-5093
Practice Address - Country:US
Practice Address - Phone:801-277-8233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-21
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT295385-99211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice