Healthcare Provider Details

I. General information

NPI: 1720146830
Provider Name (Legal Business Name): WENDELL HILL TAYLOR JR. D.M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 CAHABA RD
BIRMINGHAM AL
35223-2623
US

IV. Provider business mailing address

3300 CAHABA RD
BIRMINGHAM AL
35223-2623
US

V. Phone/Fax

Practice location:
  • Phone: 205-879-5216
  • Fax:
Mailing address:
  • Phone: 205-879-5216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number3898
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: