IndividualActive
Taylor Pettit, DDS
NPI 1982448759 · General Practice Dentistry · Logan, UT
Taylor Pettit, DDS is a General Practice Dentistry provider in Logan, UT (NPI 1982448759).
Provider details
- NPI number
- 1982448759
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 14038757-9923 (UT)
Practice location
167 E 200 N Ste 3
Logan, UT 84321-4049
Phone: (435) 363-3584
Street-level locationGet directions
Mailing address
197 Evergreen Dr
Idaho Falls, ID 83401-2907
Registry dates
- Enumerated
- 2024-06-25
- Last updated
- 2024-07-02
- Certified
- 2024-07-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.