Individual
DR. TAYLOR COLLAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 E 15TH ST STE 520, FORT WORTH, TX 76102-6566
(817) 529-8151
(817) 394-1911
Mailing address
100 E 15TH ST STE 520, FORT WORTH, TX 76102-6566
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
30725
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
4020
AR
Other
Enumeration date
05/13/2015
Last updated
05/13/2015
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