Provider Demographics
NPI:1518737600
Name:ANDREW T. TAYLOR, DMD, PLLC
Entity Type:Organization
Organization Name:ANDREW T. TAYLOR, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:720-924-6061
Mailing Address - Street 1:10997 TIMOTHYS DR
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-8227
Mailing Address - Country:US
Mailing Address - Phone:781-258-4602
Mailing Address - Fax:
Practice Address - Street 1:460 COUNTY ROAD 43 STE 3
Practice Address - Street 2:
Practice Address - City:BAILEY
Practice Address - State:CO
Practice Address - Zip Code:80421-2504
Practice Address - Country:US
Practice Address - Phone:720-924-6061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental