Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 4987 | OR |
NPI | 1013039700 |
---|---|
Provider Name | Dr. David Verne Taylor |
First Address | Hood River, OR 97031-1657 |
Second Address | Hood River, OR 97031-1657 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 08/07/2007 |