Provider Demographics
NPI:1578122461
Name:HARTLEY, TAYLOR ELIZABETH (DMD)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:ELIZABETH
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 GROVE HILL LN
Mailing Address - Street 2:
Mailing Address - City:ZELIENOPLE
Mailing Address - State:PA
Mailing Address - Zip Code:16063-3038
Mailing Address - Country:US
Mailing Address - Phone:724-417-0327
Mailing Address - Fax:
Practice Address - Street 1:4075 MONROEVILLE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2529
Practice Address - Country:US
Practice Address - Phone:412-856-4877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA00000000000122300000X
PADS-042252122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist