Provider Demographics
NPI:1174603195
Name:H DIXON TAYLOR DDS A PROF CORP
Entity type:Organization
Organization Name:H DIXON TAYLOR DDS A PROF CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:H
Authorized Official - Middle Name:DIXON
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS MDS
Authorized Official - Phone:925-689-9350
Mailing Address - Street 1:4501 COWELL ROAD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-1903
Mailing Address - Country:US
Mailing Address - Phone:925-689-9350
Mailing Address - Fax:925-689-3445
Practice Address - Street 1:4501 COWELL ROAD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-1903
Practice Address - Country:US
Practice Address - Phone:925-689-9350
Practice Address - Fax:925-689-3445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA329101223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty