Provider Demographics
NPI:1205407301
Name:NEWMAN, TAYLOR ANDERSON (DMD, MMS)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:ANDERSON
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DMD, MMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4681 CANTER ROW
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-5080
Mailing Address - Country:US
Mailing Address - Phone:540-320-7398
Mailing Address - Fax:
Practice Address - Street 1:1308 W NINE MILE RD STE 9
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32534-1761
Practice Address - Country:US
Practice Address - Phone:850-484-4844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL262491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice