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General NPI Number Information
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NPI Number | 1902145998
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Entity Type | Organization
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Legal Business Name | TAYLOR ORTHODONTICS PLLC
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Dates
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Enumeration Date | 02/11/2013
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Last Update Date | 02/11/2013
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Provider Practice Location Address
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Address Line | 1530 BREEZEPORT WAY STE 500
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City | SUFFOLK
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State | VA
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Zip | 23435-3756
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Country | US
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Telephone | 757-686-3444
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Fax |
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Provider Business Mailing Address
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Address Line | 1530 BREEZEPORT WAY STE 500
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City | SUFFOLK
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State | VA
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Zip | 23435-3756
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | INSURANCE COORDINATIOR
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Name | ERIN L ZAUNER
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Credential |
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Telephone | 757-686-3444
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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 | 0401413529
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License Number State | VA
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