Individual
AMANDA TINESHA TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
117 SAINT PATRICKS DR, WALDORF, MD 20603-4574
(301) 870-4553
Mailing address
15046 BARNES MEADOWS CT, WOODBRIDGE, VA 22193-3188
(919) 260-5850
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401416758
VA
1223G0001X
General Practice Dentistry
Primary
17231
MD
1223G0001X
General Practice Dentistry
29790
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/03/2013
Last updated
02/22/2020
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