Provider Demographics
NPI:1487182085
Name:TAYLOR, STEVEN JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JAY
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 S MINNESOTA ST
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-3002
Mailing Address - Country:US
Mailing Address - Phone:507-359-2047
Mailing Address - Fax:
Practice Address - Street 1:20 S MINNESOTA ST
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-3002
Practice Address - Country:US
Practice Address - Phone:507-359-2047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND138101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice