Healthcare Provider Details

I. General information

NPI: 1760095905
Provider Name (Legal Business Name): TAYLOR R TOWNSEND RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2020
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 S 27TH ST
BILLINGS MT
59101-4227
US

IV. Provider business mailing address

123 S 27TH ST
BILLINGS MT
59101-4227
US

V. Phone/Fax

Practice location:
  • Phone: 406-247-3333
  • Fax: 406-247-3334
Mailing address:
  • Phone: 406-247-3333
  • Fax: 406-247-3334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: