Provider Demographics
NPI:1922738947
Name:SWALLOW, JOHN TAYLOR (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:TAYLOR
Last Name:SWALLOW
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 1:366 S 500 E
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2526
Mailing Address - Country:US
Mailing Address - Phone:801-756-2809
Mailing Address - Fax:
Practice Address - Street 1:366 S 500 E
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2526
Practice Address - Country:US
Practice Address - Phone:801-756-2809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12884769-99231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice