# DR. RUSSELL DEMETRIUS TAYLOR III

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1124387683
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 35703 | TX | Yes |
| 1223G0001X | General Practice Dentistry | 81236609921 | UT | — |

## Other

- **Enumeration date:** 05/03/2012
- **Last updated:** 02/15/2022