Provider Demographics
NPI:1124759071
Name:YOUNG, TAYLOR (DDS)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 LINCOLN AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-2212
Mailing Address - Country:US
Mailing Address - Phone:319-899-7846
Mailing Address - Fax:
Practice Address - Street 1:1201 S HIGHLAND AVE STE 3
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-4359
Practice Address - Country:US
Practice Address - Phone:727-475-5402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN27111122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist