Provider Demographics
NPI:1104937887
Name:STEVEN E. TAYLOR DDS MS PC
Entity type:Organization
Organization Name:STEVEN E. TAYLOR DDS MS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:573-446-7259
Mailing Address - Street 1:1100 CLUB VILLAGE DRIVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203
Mailing Address - Country:US
Mailing Address - Phone:573-446-7259
Mailing Address - Fax:
Practice Address - Street 1:1400 FORUM BLVD
Practice Address - Street 2:SUITE 12
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-1997
Practice Address - Country:US
Practice Address - Phone:573-446-7259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20010326001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty