Provider Demographics
NPI:1699923979
Name:TAYLOR, SCOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
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 1:685 MAIN ST. SUITE C
Mailing Address - Street 2:MORRO BAY DENTISTRY
Mailing Address - City:MORRO BAY
Mailing Address - State:CA
Mailing Address - Zip Code:93442
Mailing Address - Country:US
Mailing Address - Phone:805-772-8143
Mailing Address - Fax:
Practice Address - Street 1:685 MAIN ST. SUITE C
Practice Address - Street 2:MORRO BAY DENTISTRY
Practice Address - City:MORRO BAY
Practice Address - State:CA
Practice Address - Zip Code:93442
Practice Address - Country:US
Practice Address - Phone:805-772-8143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57568122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist