Provider Demographics
NPI:1568515237
Name:TAYLOR, CARMAC DAWELL JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARMAC
Middle Name:DAWELL
Last Name:TAYLOR
Suffix:JR
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 1:2 OAKTREE ST
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-4073
Mailing Address - Country:US
Mailing Address - Phone:281-482-2631
Mailing Address - Fax:281-482-3226
Practice Address - Street 1:2 OAKTREE ST
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-4073
Practice Address - Country:US
Practice Address - Phone:281-482-2631
Practice Address - Fax:281-482-3226
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice