Provider Demographics
NPI:1700616786
Name:TRAWICK, TAYLOR BRYANT (DDS)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:BRYANT
Last Name:TRAWICK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 KENILWORTH ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-2804
Mailing Address - Country:US
Mailing Address - Phone:850-293-7951
Mailing Address - Fax:
Practice Address - Street 1:2217 OLAN MILLS DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1891
Practice Address - Country:US
Practice Address - Phone:423-894-5607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN124481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice