Individual
DR. TAYLOR RUSSEL SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1059 BARTON DR, FORDLAND, MO 65652-7350
(417) 767-2273
(417) 767-2273
Mailing address
1059 BARTON DR, FORDLAND, MO 65652-7350
(417) 767-2273
(417) 767-4054
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2020018039
MO
122300000X
Dentist
7336
OK
Other
Enumeration date
05/07/2020
Last updated
08/10/2021
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