Provider Demographics
NPI:1578697942
Name:TAYLOR, WILLIAM B (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
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 1:1050 WISCONSIN ST
Mailing Address - Street 2:POTRERO HILL HLTH CTR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-3328
Mailing Address - Country:US
Mailing Address - Phone:415-920-1230
Mailing Address - Fax:
Practice Address - Street 1:1050 WISCONSIN ST
Practice Address - Street 2:POTRERO HALL HEALTH CENTER
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-3328
Practice Address - Country:US
Practice Address - Phone:415-920-1230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33D629111122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist