Individual
KEVIN TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2211 EXECUTIVE ST, SUITE E, CHARLOTTE, NC 28208-3661
(704) 395-6000
(704) 398-7373
Mailing address
3212 S WILMINGTON ST, RALEIGH, NC 27603-3538
(919) 773-3002
(919) 773-8824
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9003
NC
Other
Enumeration date
06/28/2010
Last updated
06/12/2013
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