Provider Demographics
NPI:1649431966
Name:TAYLOR, MARJORIE (DDS)
Entity type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:
Last Name:TAYLOR
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 1:2466 E KIMBERLY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2338
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2466 E KIMBERLY RD
Practice Address - Street 2:SUITE B
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2338
Practice Address - Country:US
Practice Address - Phone:563-359-4270
Practice Address - Fax:563-359-4320
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA62891223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics