Individual
DR. BRYCE JOHN BOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
745 N 500 W STE 103, PROVO, UT 84601-1475
(801) 373-4200
Mailing address
745 N 500 W STE 103, PROVO, UT 84601-1475
(801) 373-4200
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
138
NE
1223P0221X
Pediatric Dentistry
Primary
9813262-9923
UT
Other
Enumeration date
10/03/2016
Last updated
01/09/2020
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