Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0221X | Pediatric Dentist | 0007070 | TN |
N | 1223P0221X | Pediatric Dentist | 011461 | GA |
N | 1223P0221X | Pediatric Dentist | 11194 | MD |
Y | 1223P0221X | Pediatric Dentist | DN0013359 | FL |
NPI | 1023397023 |
---|---|
Provider Name | Dr. Lincoln Boyd Taylor |
First Address | Oviedo, FL 32765 |
Second Address | Oviedo, FL 32765 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2011 |
Last Update Date | 08/08/2011 |