Individual
DR. THAD TAYLOR IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2630 S CARRIER PKWY, SUITE C, GRAND PRAIRIE, TX 75052-5069
(214) 762-1474
(972) 572-3900
Mailing address
2630 S CARRIER PKWY, SUITE C, GRAND PRAIRIE, TX 75052-5069
(214) 762-1474
(972) 572-3900
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
18948
TX
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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