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Individual

DR. HERMAN MARSEL TAYLOR

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1951 EAST 79TH ST, CHICAGO, IL 60649
(773) 221-4071
(773) 221-9602
Mailing address
1951 EAST 79TH ST, CHICAGO, IL 60649
(773) 221-4071
(773) 221-9602

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19015567
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101219
IL
Enumeration date
11/10/2005
Last updated
07/08/2007
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