Provider Demographics
NPI:1750458279
Name:KERRY LYNN TAYLOR DDS
Entity Type:Organization
Organization Name:KERRY LYNN TAYLOR DDS
Other - Org Name:CHANDLER DENTAL EXCELLENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-786-1734
Mailing Address - Street 1:855 E WARNER RD
Mailing Address - Street 2:SUITE #104
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225
Mailing Address - Country:US
Mailing Address - Phone:480-786-1734
Mailing Address - Fax:480-899-5851
Practice Address - Street 1:855 E WARNER RD
Practice Address - Street 2:SUITE #104
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225
Practice Address - Country:US
Practice Address - Phone:480-786-1734
Practice Address - Fax:480-899-5851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty