MEDICARE: DR. PAULA A TAYLOR DDS

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	122300000X	Dentist	2901016758	MI
2	1223G0001X	General Practice Dentistry	2901016758	MI

General Provider Information

NPI Number	:	1689786980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAULA A TAYLOR DDS

Provider Business Mailing Address
First Line	:	626 N CROOKS RD
Second Line	:
City	:	CLAWSON
State	:	MI
Zip	:	48017-1310
Country	:	US
Telephone Number	:	248-435-9215
Fax Number	:	248-435-6322

Provider Business Practice Location Address
First Line	:	39890 W 14 MILE RD
Second Line	:
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48390-3911
Country	:	US
Telephone Number	:	248-624-8090
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	10/20/2022

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