Provider Demographics
NPI:1154778041
Name:TAYLOR, ROBERT CLAY (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CLAY
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E CARMEL DR
Mailing Address - Street 2:SUITE H100
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2888
Mailing Address - Country:US
Mailing Address - Phone:317-571-1271
Mailing Address - Fax:
Practice Address - Street 1:301 E CARMEL DR
Practice Address - Street 2:SUITE H100
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2888
Practice Address - Country:US
Practice Address - Phone:317-571-1271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012481A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice