Provider Demographics
NPI:1194716217
Name:TAYLOR, TREVOR K (DMD)
Entity type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:K
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DMD
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Mailing Address - Street 1:6435 W HIGHWAY 146
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-9575
Mailing Address - Country:US
Mailing Address - Phone:502-241-1515
Mailing Address - Fax:502-241-1521
Practice Address - Street 1:6435 W HIGHWAY 146
Practice Address - Street 2:SUITE 1
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014-9575
Practice Address - Country:US
Practice Address - Phone:502-241-1515
Practice Address - Fax:502-241-1521
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY76231223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics