Provider Demographics
NPI:1902823404
Name:TAYLOR, STEVEN EDWIN (DDS)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:EDWIN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1413 ANNAPOLIS ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113
Mailing Address - Country:US
Mailing Address - Phone:410-674-5233
Mailing Address - Fax:410-674-5233
Practice Address - Street 1:1413 ANNAPOLIS ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113
Practice Address - Country:US
Practice Address - Phone:410-674-5233
Practice Address - Fax:410-674-3174
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10699204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
T60022Medicare UPIN