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NPI Code Detail

MEDICARE: TAYLOR AMANDA ROTTO

MEDICARE: TAYLOR AMANDA ROTTO
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
11223P0221XPediatric Dentistry42115TX

General Provider Information

NPI Number : 1457053365
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR AMANDA ROTTO
Provider Business Mailing Address
First Line : 841 N NOLAN RIVER RD
Second Line :
City : CLEBURNE
State : TX
Zip : 76033-7001
Country : US
Telephone Number : 817-382-3029
Fax Number :
Provider Business Practice Location Address
First Line : 841 N NOLAN RIVER RD
Second Line :
City : CLEBURNE
State : TX
Zip : 76033-7001
Country : US
Telephone Number : 817-382-3029
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2023
Last Update Date : 12/18/2025

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Directions to “ TAYLOR AMANDA ROTTO ” Practice Location

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