Organization
JEFFERY Y. TAYLOR DMD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN PAGITT (FINANCIAL COORDINATOR)
(228) 896-4325
Entity
Organization
Contact information
Practice address
431 SECURITY SQ, GULFPORT, MS 39507-1922
(228) 896-4325
(228) 896-5787
Mailing address
431 SECURITY SQ, GULFPORT, MS 39507-1922
(228) 896-4325
(228) 896-5787
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
PER24293
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
696993
ACTIVE DUTY MILITARY
—
Enumeration date
10/24/2006
Last updated
08/22/2020
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