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General NPI Number Information
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NPI Number | 1326619594
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Entity Type | Individual
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Provider Name | TAYLOR EDWARD MCGREEVEY DMD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2021
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Last Update Date | 07/08/2021
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Provider Practice Location Address
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Address Line | 5577 US HIGHWAY 93 N
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City | FLORENCE
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State | MT
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Zip | 59833-6845
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Country | US
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Telephone | 406-273-2015
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 SW HIGGINS AVE APT L
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City | MISSOULA
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State | MT
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Zip | 59803-3603
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Country | US
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Telephone | 406-546-1932
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN-DEN-LIC-21457
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License Number State | MT
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