Provider Demographics
NPI:1437936416
Name:LIGHT, TAYLOR MORGAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:MORGAN
Last Name:LIGHT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 BRICKELL BAY DR APT 3111
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2965
Mailing Address - Country:US
Mailing Address - Phone:786-301-8488
Mailing Address - Fax:
Practice Address - Street 1:1111 BRICKELL BAY DR APT 3111
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2965
Practice Address - Country:US
Practice Address - Phone:786-301-8488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28293122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist