Provider Demographics
NPI:1962416859
Name:TAYLOR, DAVID MERRICK (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MERRICK
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 1:550 DEEP VALLEY DR
Mailing Address - Street 2:SUITE 345
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3664
Mailing Address - Country:US
Mailing Address - Phone:310-377-4551
Mailing Address - Fax:310-541-6042
Practice Address - Street 1:550 DEEP VALLEY DR
Practice Address - Street 2:SUITE 345
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3664
Practice Address - Country:US
Practice Address - Phone:310-377-4551
Practice Address - Fax:310-541-6042
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA233891223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry