Provider Demographics
NPI:1073616421
Name:TAYLOR, CHARLES M III (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:M
Last Name:TAYLOR
Suffix:III
Gender:M
Credentials:DDS
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Mailing Address - Street 1:5200 BUFFALO GAP RD
Mailing Address - Street 2:BLDG C
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606
Mailing Address - Country:US
Mailing Address - Phone:325-695-0170
Mailing Address - Fax:325-695-2908
Practice Address - Street 1:5200 BUFFALO GAP RD
Practice Address - Street 2:BLDG C
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606
Practice Address - Country:US
Practice Address - Phone:325-695-0170
Practice Address - Fax:325-695-2908
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX131451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics