Provider Demographics
NPI:1710056205
Name:KAYLOR, DOUGLAS EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:EUGENE
Last Name:KAYLOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 BAILEY AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:NEEDLES
Mailing Address - State:CA
Mailing Address - Zip Code:92363-3115
Mailing Address - Country:US
Mailing Address - Phone:760-326-4541
Mailing Address - Fax:760-326-3844
Practice Address - Street 1:1406 BAILEY AVE
Practice Address - Street 2:SUITE F
Practice Address - City:NEEDLES
Practice Address - State:CA
Practice Address - Zip Code:92363-3115
Practice Address - Country:US
Practice Address - Phone:760-326-4541
Practice Address - Fax:760-326-3844
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA285811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice