Provider Demographics
NPI:1689795932
Name:S. CRAIG TAYLOR, D.M.D., P.C.
Entity Type:Organization
Organization Name:S. CRAIG TAYLOR, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-267-4404
Mailing Address - Street 1:303 S BROAD ST
Mailing Address - Street 2:PO BOX 208
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-2119
Mailing Address - Country:US
Mailing Address - Phone:770-267-4404
Mailing Address - Fax:770-267-4366
Practice Address - Street 1:303 S BROAD ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-2119
Practice Address - Country:US
Practice Address - Phone:770-267-4404
Practice Address - Fax:770-267-4366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA92081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty