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NPI Code Detail

MEDICARE: DR. NAQUIDA LEISHA TAYLOR D.D.S

MEDICARE: DR. NAQUIDA LEISHA 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
11223G0001XGeneral Practice Dentistry30.023595OH

General Provider Information

NPI Number : 1740567064
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NAQUIDA LEISHA TAYLOR D.D.S
Provider Business Mailing Address
First Line : 1517 E 45TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-3003
Country : US
Telephone Number : 646-469-1673
Fax Number :
Provider Business Practice Location Address
First Line : 716 TOD AVE SW
Second Line :
City : WARREN
State : OH
Zip : 44485-3608
Country : US
Telephone Number : 330-747-9551
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2011
Last Update Date : 11/15/2011

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