Basic Information
| Provider Information | |||||||||
| NPI: | 1881981595 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAYLOR | ||||||||
| FirstName: | CURTIS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 712 SAINT JOHN ST | ||||||||
| Address2: | PO BOX 766 | ||||||||
| City: | GARDEN CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 678465128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202720570 | ||||||||
| FaxNumber: | 6202754729 | ||||||||
| Practice Location | |||||||||
| Address1: | 310 E WALNUT ST STE LL5 | ||||||||
| Address2: | |||||||||
| City: | GARDEN CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 678465572 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202720570 | ||||||||
| FaxNumber: | 6202710582 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2011 | ||||||||
| LastUpdateDate: | 07/01/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 60814 | KS | Y | Dental Providers | Dentist | General Practice |
No ID Information.