Provider Demographics
NPI:1982918066
Name:TAYLOR, ELIZABETH SCHMIDT (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:SCHMIDT
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715A DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39530-2209
Mailing Address - Country:US
Mailing Address - Phone:228-374-4991
Mailing Address - Fax:228-374-2713
Practice Address - Street 1:715A DIVISION ST
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-2209
Practice Address - Country:US
Practice Address - Phone:228-374-4991
Practice Address - Fax:228-374-2713
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2575-901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice