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General NPI Number Information
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NPI Number | 1104569540
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Entity Type | Organization
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Legal Business Name | SCOTT W. TAYLOR D.D.S, P.C.
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 1055 W FAIR AVE
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City | MARQUETTE
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State | MI
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Zip | 49855-2665
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Country | US
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Telephone | 906-228-6309
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Fax | 906-264-5007
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Provider Business Mailing Address
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Address Line | 1055 W FAIR AVE
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City | MARQUETTE
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State | MI
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Zip | 49855-2665
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Country | US
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Telephone | 906-228-6309
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Fax | 906-264-5007
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Authorized Official
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Title or Position | ASSISTANT OFFICE MANAGER
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Name | MRS. KRYSTA JEAN CARROLL
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Credential |
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Telephone | 906-228-6309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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