MEDICARE: DR. RAMONA APPLEWHITE TAYLOR D.D.S.

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	1223G0001X	General Practice Dentistry	18732	TX

General Provider Information

NPI Number	:	1275609224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMONA APPLEWHITE TAYLOR D.D.S.

Provider Business Mailing Address
First Line	:	4927 LAKE RIDGE PKWY
Second Line	:	STE 140
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-3087
Country	:	US
Telephone Number	:	817-591-7800
Fax Number	:	214-235-0717

Provider Business Practice Location Address
First Line	:	4927 LAKE RIDGE PKWY
Second Line	:	STE 140
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-3087
Country	:	US
Telephone Number	:	817-591-7800
Fax Number	:	682-323-8456

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	12/08/2015

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