Provider Demographics
NPI:1609982487
Name:KAYLOR-SPEIGHT, ELIZABETH (RDH)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:KAYLOR-SPEIGHT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:KAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27 ORCHARD STREET
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:NY
Mailing Address - Zip Code:10901
Mailing Address - Country:US
Mailing Address - Phone:845-368-2503
Mailing Address - Fax:
Practice Address - Street 1:163 CITY ISLAND AVENUE
Practice Address - Street 2:
Practice Address - City:CITY ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10464
Practice Address - Country:US
Practice Address - Phone:718-885-1688
Practice Address - Fax:718-885-9638
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018454124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist