Organization
GARY N TAYLOR DDS, MS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY NORMAN TAYLOR DDS (PRESIDENT)
(708) 579-0488
Entity
Organization
Contact information
Practice address
475 W 55TH ST, SUITE 208, COUNTRYSIDE, IL 60525-3564
(708) 579-0488
Mailing address
475 W 55TH ST, SUITE 208, COUNTRYSIDE, IL 60525-3564
(708) 579-0488
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
021-000978
IL
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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