Provider Demographics
NPI:1831475375
Name:TAYLOR, RYAN B (DMD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:B
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 OAK PARK DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75232-1178
Mailing Address - Country:US
Mailing Address - Phone:970-223-8687
Mailing Address - Fax:
Practice Address - Street 1:1220 OAK PARK DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75232-1178
Practice Address - Country:US
Practice Address - Phone:970-223-8687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002025361223P0221X
ORD96831223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry