Individual
TAYLOR STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
250 CENTRAL AVE N, SUITE 113, WAYZATA, MN 55391-1206
(952) 475-3135
Mailing address
250 CENTRAL AVE N, SUITE 113, WAYZATA, MN 55391-1206
(952) 475-3135
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D12818
MN
390200000X
Student in an Organized Health Care Education/Training Program
2728
OH
Other
Enumeration date
06/09/2008
Last updated
01/14/2014
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