Clark, Taylor
Clark, Taylor is an individual health care provider with primary practice located at 3 Road 6523 , Kirtland NM 87417-9452. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Clark, Taylor can be contacted via phone (505) 598-6800.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 6577 | Arizona |
| Dental Providers / Dentist | 122300000X | 3385 | New Mexico |
Profile Details
| NPI number | 1336155571 |
|---|---|
| LBN Legal business name | Clark, Taylor |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 31st, 2006 |
| Last updated | Aug 9th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336155571 | NPPES |
| Arizona | MEDICAID | 947963 |
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