Healthcare Provider Details

I. General information

NPI: 1124110341
Provider Name (Legal Business Name): RONALD SCOTT TAYLOR D.M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 10/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 OLD FORT PKWY
MURFREESBORO TN
37128-4158
US

IV. Provider business mailing address

2910 OLD FORT PKWY
MURFREESBORO TN
37128-4158
US

V. Phone/Fax

Practice location:
  • Phone: 615-494-5437
  • Fax:
Mailing address:
  • Phone: 615-494-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN14087
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number10637
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: