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General NPI Number Information
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NPI Number | 1104086735
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Entity Type | Individual
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Provider Name | CRAIG LYNN TAYLOR DMD
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Gender | Male
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 7816 RESEARCH BLVD., #125
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City | AUSTIN
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State | TX
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Zip | 78758-7861
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Country | US
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Telephone | 512-454-4646
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Fax |
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Provider Business Mailing Address
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Address Line | 310 PARKE WIND WAY
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City | CEDAR PARK
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State | TX
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Zip | 78613-3191
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Country | US
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Telephone | 254-339-9251
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 25175
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 00000000000000000000
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 25175
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License Number State | TX
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