Individual
KELLY TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
82 LYNN DR, SANTA ROSA BEACH, FL 32459-4200
(850) 974-0780
Mailing address
10 LUCILE ST UNIT E, FORT WALTON BEACH, FL 32548-4491
(850) 376-4262
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH11693
FL
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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