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Individual

DR. DENNIS R TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
714 S GRAND AVE, SPENCER, IA 51301-5730
(712) 262-3982
(712) 262-7831
Mailing address
1122 18TH AVE W, SPENCER, IA 51301-2725
(712) 262-4785

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1697
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0162826
IA
01
16282
BCBS
IA
01
410008780
RR MCR
Enumeration date
01/22/2007
Last updated
07/08/2007
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