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NPI 1114499977

NPI 1114499977 : ROBERT TAYLOR DDS, PC : CARMEL, IN

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General NPI Number Information
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    NPI Number           |    1114499977
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    Entity Type          |    Organization 
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    Legal Business Name  |    ROBERT TAYLOR DDS, PC 
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Dates
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    Enumeration Date     |    12/18/2018
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    Last Update Date     |    12/18/2018
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Provider Practice Location Address
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    Address Line         |    301 E CARMEL DR STE H100 
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    City                 |    CARMEL
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    State                |    IN
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    Zip                  |    46032-2897
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    Country              |    US
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    Telephone            |    317-571-1271
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    Fax                  |    317-571-1099
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Provider Business Mailing Address
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    Address Line         |    301 E CARMEL DR STE H100 
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    City                 |    CARMEL
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    State                |    IN
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    Zip                  |    46032-2897
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    Country              |    US
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    Telephone            |    317-571-1271
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    Fax                  |    317-571-1099
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     ROBERT  TAYLOR 
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    Credential           |    DDS
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    Telephone            |    317-571-1271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    
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    License Number State |    
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