Provider Demographics
NPI:1700813466
Name:TAYLOR, MEREDITH DUCKWORTH (DENTIST)
Entity Type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:DUCKWORTH
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 ROSEWOOD CENTRE DR
Mailing Address - Street 2:SUITE #200
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-9451
Mailing Address - Country:US
Mailing Address - Phone:919-290-2772
Mailing Address - Fax:919-290-2773
Practice Address - Street 1:190 ROSEWOOD CENTRE DR
Practice Address - Street 2:SUITE #200
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9451
Practice Address - Country:US
Practice Address - Phone:919-290-2772
Practice Address - Fax:919-290-2773
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC76011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89902VVMedicaid