Provider Demographics
NPI:1346839123
Name:FRANCIS, TAYLOR BRETT (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:BRETT
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5108 W GORE BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6025
Mailing Address - Country:US
Mailing Address - Phone:580-248-7600
Mailing Address - Fax:
Practice Address - Street 1:5108 W GORE BLVD STE 4
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6025
Practice Address - Country:US
Practice Address - Phone:580-248-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7044122300000X
OK2411223X0008X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty
No1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology