FDC of Laurel LLC

Organization Active NPI General Practice Dentistry · Laurel, MS

NPI 1124599105 · NPPES record last updated Dec 17, 2018

Key facts

NPI
1124599105
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
FDC OF LAUREL LLC
Practice address
1532 W 15TH St
Laurel, MS 39440-2102
Phone
(601) 428-0082
NPI assigned
Dec 17, 2018
Organization subpart
No

Authorized official

Name
Dr. Shelley S. Taylor, DMD
Title
Owner/Dentist
Phone
(601) 428-0082

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

1532 W 15TH St
Laurel, MS 39440-2102

Mailing address

PO Box 6505
Laurel, MS 39441-6505
Phone (601) 428-0082

Other names

  • Family Dental Center of Laurel Doing business as

Other providers in Laurel, MS

All providers in Laurel, MS · General Practice Dentistry in Mississippi

Sources for this page

Verify at the official NPI Registry.