Organization
J TAYLOR DMD PC
Active
Other names
Valley Wide Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORDAN H TAYLOR DMD (PRESIDENT)
(256) 694-0278
Entity
Organization
Contact information
Practice address
1616 PULASKI PIKE NW, HUNTSVILLE, AL 35816-2534
(256) 536-2771
Mailing address
1616 PULASKI PIKE NW, HUNTSVILLE, AL 35816-2534
(256) 536-2771
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6096
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163600
—
AL
Enumeration date
07/25/2018
Last updated
07/25/2018
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