Healthcare Provider Details

I. General information

NPI: 1598685109
Provider Name (Legal Business Name): TAYLOR FORSTNER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MEDICAL CENTER DR STE 490
FAIRMONT MN
56031-4575
US

IV. Provider business mailing address

800 MEDICAL CENTER DR STE 490
FAIRMONT MN
56031-4575
US

V. Phone/Fax

Practice location:
  • Phone: 507-432-3199
  • Fax:
Mailing address:
  • Phone: 507-432-3199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD15520
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: