Provider Demographics
NPI:1396237863
Name:TAYLOR, MAEGEN MONE (RDH)
Entity type:Individual
Prefix:MRS
First Name:MAEGEN
Middle Name:MONE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 S BUSINESS HIGHWAY 13
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:64067-1437
Mailing Address - Country:US
Mailing Address - Phone:660-259-4371
Mailing Address - Fax:660-259-6250
Practice Address - Street 1:547 S BUSINESS HIGHWAY 13
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MO
Practice Address - Zip Code:64067
Practice Address - Country:US
Practice Address - Phone:660-259-4371
Practice Address - Fax:660-259-6250
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004015641124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist