Provider Demographics
NPI:1750483004
Name:TAYLOR, PRUDENCE HARRIETT (DDS)
Entity type:Individual
Prefix:DR
First Name:PRUDENCE
Middle Name:HARRIETT
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 1:7 GREENWOOD AVE.
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03818
Mailing Address - Country:US
Mailing Address - Phone:603-447-6707
Mailing Address - Fax:207-947-5132
Practice Address - Street 1:7 GREENWOOD AVE.
Practice Address - Street 2:SUITE 3
Practice Address - City:CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03818
Practice Address - Country:US
Practice Address - Phone:603-447-6707
Practice Address - Fax:207-947-5132
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04215122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist