Provider Demographics
NPI:1811746068
Name:SMITH, TAYLOR LEIGH (DMD)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:LEIGH
Last Name:SMITH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42D MEDICAL GROUP
Mailing Address - Street 2:300 S. TWINING ST., BUILDING 760
Mailing Address - City:MAXWELL AIR FORCE BASE
Mailing Address - State:AL
Mailing Address - Zip Code:36112-6219
Mailing Address - Country:US
Mailing Address - Phone:334-953-9127
Mailing Address - Fax:
Practice Address - Street 1:42D MEDICAL GROUP
Practice Address - Street 2:300 S. TWINING ST., BUILDING 760
Practice Address - City:MAXWELL AIR FORCE BASE
Practice Address - State:AL
Practice Address - Zip Code:36112-6219
Practice Address - Country:US
Practice Address - Phone:334-953-9127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29353122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist