Provider Demographics
NPI:1114499977
Name:ROBERT TAYLOR DDS, PC
Entity Type:Organization
Organization Name:ROBERT TAYLOR DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-571-1271
Mailing Address - Street 1:301 E CARMEL DR STE H100
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2897
Mailing Address - Country:US
Mailing Address - Phone:317-571-1271
Mailing Address - Fax:317-571-1099
Practice Address - Street 1:301 E CARMEL DR STE H100
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2897
Practice Address - Country:US
Practice Address - Phone:317-571-1271
Practice Address - Fax:317-571-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1285856229OtherNPI
IN1154778041OtherNPI