Provider Demographics
NPI:1548624547
Name:BAIRD, TAYLOR LYNN
Entity type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:LYNN
Last Name:BAIRD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 N FERGUSON AVE APT E
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6763
Mailing Address - Country:US
Mailing Address - Phone:303-810-7139
Mailing Address - Fax:
Practice Address - Street 1:45 W KAGY BLVD STE 4
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6071
Practice Address - Country:US
Practice Address - Phone:406-577-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO76853939122300000X
MT13341122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO76853939OtherDENTPIN