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NPI Code Detail

MEDICARE: DR. CATHLEEN M TAYLOR DDS

MEDICARE: DR. CATHLEEN M TAYLOR DDS
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
11223G0001XGeneral Practice DentistryKS7179KS
21223G0001XGeneral Practice Dentistry015904MO

General Provider Information

NPI Number : 1588642029
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CATHLEEN M TAYLOR DDS
Provider Business Mailing Address
First Line : PO BOX 504939
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63150-4407
Country : US
Telephone Number : 816-932-7940
Fax Number : 816-932-7957
Provider Business Practice Location Address
First Line : 2121 SUMMIT ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-2126
Country : US
Telephone Number : 816-471-0900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2006
Last Update Date : 07/12/2012

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