Individual
TAYLOR D BLAYLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3328 JENKINS RD STE 100, CHATTANOOGA, TN 37421-1297
(423) 206-9660
Mailing address
306 ENTERPRISE DR, OXFORD, MS 38655-2762
(662) 710-4244
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4067
MS
1223G0001X
General Practice Dentistry
Primary
11293
TN
1223G0001X
General Practice Dentistry
11295
KY
Other
Enumeration date
06/11/2019
Last updated
05/20/2025
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