MEDICARE: MARTIN-TAYLOR DENTISTRY

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	1223G0001X	General Practice Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417673617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTIN-TAYLOR DENTISTRY

Provider Business Mailing Address
First Line	:	7350 E SPEEDWAY BLVD STE 201
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-1366
Country	:	US
Telephone Number	:	520-747-9024
Fax Number	:	520-747-0148

Provider Business Practice Location Address
First Line	:	7350 E SPEEDWAY BLVD STE 201
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-1366
Country	:	US
Telephone Number	:	520-600-6925
Fax Number	:	520-747-0148

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	DR. WILLIAM HOWELL TAYLOR
Credential	:	DDS
Telephone Number	:	520-747-9024

Provider Enumeration Date	:	10/18/2022
Last Update Date	:	03/02/2023

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Directions to “MARTIN-TAYLOR DENTISTRY ” Practice Location

Language	Start Address	Practice Location

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