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General NPI Number Information
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NPI Number | 1104996453
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Entity Type | Organization
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Legal Business Name | DR. PENNY L. TAYLOR D.M.D.,M.S.,P.C.
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 02/17/2010
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Provider Practice Location Address
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Address Line | 2514 DANVILLE RD SW
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City | DECATUR
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State | AL
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Zip | 35603-4213
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Country | US
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Telephone | 256-351-1118
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Fax | 256-351-1142
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Provider Business Mailing Address
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Address Line | 2514 DANVILLE RD SW
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City | DECATUR
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State | AL
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Zip | 35603-4213
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Country | US
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Telephone | 256-351-1118
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Fax | 256-351-1142
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. PENNY LEE TAYLOR
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Credential | D.M.D.,M.S.,P.C.
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Telephone | 256-351-1118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 4548
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License Number State | AL
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