MEDICARE: STEVEN E. TAYLOR DDS MS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	2001032600	MO

General Provider Information

NPI Number	:	1104937887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN E. TAYLOR DDS MS PC

Provider Business Mailing Address
First Line	:	1100 CLUB VILLAGE DRIVE
Second Line	:	SUITE 103
City	:	COLUMBIA
State	:	MO
Zip	:	65203
Country	:	US
Telephone Number	:	573-446-7259
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 FORUM BLVD
Second Line	:	SUITE 12
City	:	COLUMBIA
State	:	MO
Zip	:	65203-1997
Country	:	US
Telephone Number	:	573-446-7259
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEVEN E TAYLOR
Credential	:	DDS
Telephone Number	:	573-446-7259

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	03/19/2021

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