MEDICARE: DR. TAYLOR MARIE ERNE 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	30.027980	OH

General Provider Information

NPI Number	:	1952169195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAYLOR MARIE ERNE DDS

Provider Business Mailing Address
First Line	:	4924 ROYALWOOD RD
Second Line	:
City	:	NORTH ROYALTON
State	:	OH
Zip	:	44133-4017
Country	:	US
Telephone Number	:	440-897-8452
Fax Number	:

Provider Business Practice Location Address
First Line	:	8200 AVERY RD
Second Line	:
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-1662
Country	:	US
Telephone Number	:	440-526-4866
Fax Number	:

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

Provider Enumeration Date	:	03/12/2024
Last Update Date	:	01/14/2026

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