Provider Demographics
NPI:1881478824
Name:TAYLOR CAMPBELL, DMD PLLC
Entity type:Organization
Organization Name:TAYLOR CAMPBELL, DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:601-894-1634
Mailing Address - Street 1:331 W GALLATIN ST
Mailing Address - Street 2:
Mailing Address - City:HAZLEHURST
Mailing Address - State:MS
Mailing Address - Zip Code:39083-3027
Mailing Address - Country:US
Mailing Address - Phone:601-894-1634
Mailing Address - Fax:601-894-1635
Practice Address - Street 1:331 W GALLATIN ST
Practice Address - Street 2:
Practice Address - City:HAZLEHURST
Practice Address - State:MS
Practice Address - Zip Code:39083-3027
Practice Address - Country:US
Practice Address - Phone:601-894-1634
Practice Address - Fax:601-894-1635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental