Taylor D Blaylock, DMD
Dentist, General Practice in Chattanooga, TN. Individual provider (NPI-1).
NPI number1407415656
StatusActive
Last updated in NPPESMay 20, 2025
Details
- NPI
- 1407415656
- Entity type
- Individual (NPI-1)
- Name
- Taylor D Blaylock
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 11, 2019
- Certification date
- May 6, 2025
- Last updated
- May 20, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 11293 | TN | Yes |
| 1223G0001X | Dentist, General Practice | 11295 | KY | |
| 122300000X | Dentist | 4067 | MS |
Practice location
3328 Jenkins Rd Ste 100Chattanooga, TN 37421-1297
Phone 423-206-9660
Mailing address
306 Enterprise DrOxford, MS 38655-2762
Phone 662-710-4244
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