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Organization

BEDFORD PEDIATRIC DENTISTRY, L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KYLE WAYNE TAYLOR D.D.S. (PEDIATRIC DENTIST)
(812) 355-0855
Entity
Organization

Contact information

Practice address
1618 25TH ST, BEDFORD, IN 47421-5000
(812) 355-0855
(812) 355-0858
Mailing address
1618 25TH ST, BEDFORD, IN 47421-5000
(812) 355-0855
(812) 355-0858

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
IN

Other

Enumeration date
10/29/2015
Last updated
10/29/2015
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