Provider Demographics
NPI:1275542110
Name:THE NEW PEDIATRIC DENTAL CARE OF GREATER ORLANDO, INC
Entity Type:Organization
Organization Name:THE NEW PEDIATRIC DENTAL CARE OF GREATER ORLANDO, INC
Other - Org Name:LINCOLN B TAYLOR DDS, MS
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIS/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINCOLN
Authorized Official - Middle Name:B
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-208-0288
Mailing Address - Street 1:11309 LAKE UNDERHILL RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-4427
Mailing Address - Country:US
Mailing Address - Phone:407-208-0288
Mailing Address - Fax:407-770-0171
Practice Address - Street 1:11309 LAKE UNDERHILL RD
Practice Address - Street 2:SUITE 103
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4427
Practice Address - Country:US
Practice Address - Phone:407-208-0288
Practice Address - Fax:407-770-0171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN133591223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty