Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DS020888L | PA |
NPI | 1003088048 |
---|---|
Provider Name | Dr. John E Taylor |
First Address | Schaefferstown, PA 17088 |
Second Address | Schaefferstown, PA 17088 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2008 |
Last Update Date | 31/03/2008 |