Provider Demographics
NPI:1750473088
Name:TAYLOR ORTHODONTIC SPECIALISTS, P.A.
Entity Type:Organization
Organization Name:TAYLOR ORTHODONTIC SPECIALISTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:561-558-9467
Mailing Address - Street 1:9181 GLADES RD
Mailing Address - Street 2:#120
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3942
Mailing Address - Country:US
Mailing Address - Phone:561-558-9467
Mailing Address - Fax:561-558-9313
Practice Address - Street 1:9181 GLADES RD
Practice Address - Street 2:#120
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3942
Practice Address - Country:US
Practice Address - Phone:561-558-9467
Practice Address - Fax:561-558-9313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN140871223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty