Provider Demographics
NPI:1558055095
Name:TAYLOR S EIFORD DDS LLC
Entity Type:Organization
Organization Name:TAYLOR S EIFORD DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:EIFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-973-0279
Mailing Address - Street 1:329 E 1ST ST APT 219
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-1554
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4102 ROOSEVELT BLVD STE A
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-3700
Practice Address - Country:US
Practice Address - Phone:614-973-0279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental