Provider Demographics
NPI:1164693834
Name:KRAUSE-TAYLOR P.C.
Entity Type:Organization
Organization Name:KRAUSE-TAYLOR P.C.
Other - Org Name:TOTAL CARE DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:D
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-676-1161
Mailing Address - Street 1:1545 KINGSWAY CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-1952
Mailing Address - Country:US
Mailing Address - Phone:734-676-1161
Mailing Address - Fax:734-676-0830
Practice Address - Street 1:1545 KINGSWAY CT
Practice Address - Street 2:SUITE 101
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-1952
Practice Address - Country:US
Practice Address - Phone:734-676-1161
Practice Address - Fax:734-676-0830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI109531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty