Healthcare Provider Details

I. General information

NPI: 1801950431
Provider Name (Legal Business Name): EMERY FOLGER TAYLOR JR. D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1191 CROZET AVE.
CROZET VA
22932
US

IV. Provider business mailing address

1205 RED PINE CT
CROZET VA
22932-9747
US

V. Phone/Fax

Practice location:
  • Phone: 434-823-4080
  • Fax:
Mailing address:
  • Phone: 434-823-2295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401004499
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: