Provider Demographics
NPI:1053604801
Name:TAYLOR, RONALD CHAD (DMD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:CHAD
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:CHAD
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:5239 OLD SPRINGVILLE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PINSON
Mailing Address - State:AL
Mailing Address - Zip Code:35126-7607
Mailing Address - Country:US
Mailing Address - Phone:205-853-8080
Mailing Address - Fax:205-853-8990
Practice Address - Street 1:5239 OLD SPRINGVILLE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:PINSON
Practice Address - State:AL
Practice Address - Zip Code:35126-7607
Practice Address - Country:US
Practice Address - Phone:205-853-8990
Practice Address - Fax:205-853-8990
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5834122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist