Healthcare Provider Details

I. General information

NPI: 1770367146
Provider Name (Legal Business Name): STEPHANIE TAYLOR DYE DMD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE DEE TAYLOR

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 CENTER DR RM D1-19
GAINESVILLE FL
32610-3006
US

IV. Provider business mailing address

434 NW 25TH ST
GAINESVILLE FL
32607-2689
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-7846
  • Fax:
Mailing address:
  • Phone: 813-767-6921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDRPM2610
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN28577
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: