Provider Demographics
NPI:1679254528
Name:ALDERSON, TAYLOR JANE (DMD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:JANE
Last Name:ALDERSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:JANE
Other - Last Name:WATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:498 S MAIN ST STE F
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:PA
Mailing Address - Zip Code:18801-1317
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:498 S MAIN ST STE F
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:PA
Practice Address - Zip Code:18801-1317
Practice Address - Country:US
Practice Address - Phone:570-278-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO44264122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist