Provider Demographics
NPI:1639730633
Name:ENOCHS ENGLER, TAYLOR E (DDS)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:E
Last Name:ENOCHS ENGLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:E
Other - Last Name:ENOCHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:963 PIPKIN RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-9675
Mailing Address - Country:US
Mailing Address - Phone:931-260-0179
Mailing Address - Fax:
Practice Address - Street 1:219 N OAK AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2437
Practice Address - Country:US
Practice Address - Phone:931-260-0179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN110691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice