Provider Demographics
NPI:1144714718
Name:SYLVESTER, TAYLOR EVE (DDS)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:EVE
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6509 COLISEUM BLVD UNIT 34
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3764
Mailing Address - Country:US
Mailing Address - Phone:318-443-7080
Mailing Address - Fax:
Practice Address - Street 1:2014 GUS KAPLAN DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3358
Practice Address - Country:US
Practice Address - Phone:318-443-7080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA68901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice