MEDICARE: MARIAH TAYLOR RDH AP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	H010216	AZ

General Provider Information

NPI Number	:	1144083759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAH TAYLOR RDH AP

Provider Business Mailing Address
First Line	:	1285 E SUNSET DR
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-2942
Country	:	US
Telephone Number	:	520-442-0332
Fax Number	:

Provider Business Practice Location Address
First Line	:	1285 E SUNSET DR
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-2942
Country	:	US
Telephone Number	:	806-292-9115
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2024
Last Update Date	:	04/03/2026

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Directions to “ MARIAH TAYLOR RDH AP” Practice Location

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