DR. CLARK O TAYLOR (NPI# 1689745804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689745804 |
| Entity Type | Individual |
| Full Name | DR. CLARK O TAYLOR |
| Credential | M.D.,D.D.S. |
| Practice Address |
805 S Reserve St Missoula MT 59801-2104 |
| Practice Telephone | 4065496600 |
| Mailing Telephone | 4065496600 |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2011-03-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | 7822 | MT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 1689745804 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568019107 | Clark Taylor | Non-emergency Medical Transport (VAN) | 8561 Milsap Ct, Elk Grove, CA 95624-1269 | 2019-08-19 |
| 1750947735 | Clark Keith Taylor II | Student in an Organized Health Care Education/Training Program | 20 York St, New Haven, CT 06510-3220 | 2019-05-14 |
| 1023352531 | Clark Taylor | Counselor | 10751 Dale Ave, Stanton, CA 90680-2604 | 2012-11-21 |
| Street Address |
805 S RESERVE ST |
| City | MISSOULA |
| State | MT |
| Zip Code | 59801-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588608616 | Richard Frederick John Holtzen IIi | Dentist | 805 S Reserve St, Missoula, MT 59801-2104 | 2006-06-16 |
| 1346642998 | Surgical Sleep Solutions Pllc | Oral & Maxillofacial Surgery | 805 S Reserve St, Missoula, MT 59801-2104 | 2014-09-25 |
| 1407116338 | Facial Plastic and Reconstructive Surgery Montana PC | Clinic/Center | 805 S Reserve St, Missoula, MT 59801-2104 | 2012-05-25 |
| 1174661011 | Lisa Lya Pacheco | Neuromusculoskeletal Medicine & OMM | 805 S Reserve St, Missoula, MT 59801 | 2007-02-02 |
| 1134286883 | Facial Plastic & Reconstructive Surgery Montana PC | Clinic/Center | 805 S Reserve St, Missoula, MT 59801-2104 | 2007-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681010 | Time To Thrive Pllc | Social Worker | 1836 South Ave. West, Missoula, MT 59801 | 2020-08-26 |
| 1740815653 | Yuzo Fujiki | Specialist/Technologist | 210 N California St 104, Missoula, MT 59801 | 2020-03-11 |
| 1407346596 | Stepping Stones Counseling, Pllc | Counselor | 202 Brooks St Ste 300, Missoula, MT 59801 | 2018-05-14 |
| 1437668530 | Rejuve Care Clinic, Inc | Plastic Surgery | 715 Kensingten, Ste 1, Missoula, Missoula, MT 59801 | 2017-09-21 |
| 1619499555 | Beatrice Elise Powers | Specialist/Technologist | 410 B Stephens Ave, Missoula, MT 59801 | 2017-07-12 |
| 1770012197 | Hannah Lepiane | Massage Therapist | 1313 S. 4th W., Missoula, MT 59801 | 2017-06-08 |
| 1811420227 | Celeste Willis | Social Worker | 1055 W. Sussex, Missoula, MT 59801 | 2017-04-04 |
| 1073050498 | Rina Kasuga | Specialist/Technologist | 913 Rimini Ct, Missoula, MT 59801 | 2017-01-24 |
| 1043756919 | Heather Bartz | Specialist/Technologist | 831 Hastings Ave, Missoula, MT 59801 | 2017-01-16 |
| 1255874517 | Sarabeth Haddad | Social Worker | 1055 W Sussex Ave, Missoula, MT 59801 | 2016-11-18 |
| Find all providers in zip 59801 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346642998 | Surgical Sleep Solutions Pllc | Oral & Maxillofacial Surgery | 805 S Reserve St, Missoula, MT 59801-2104 | 2014-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457573727 | Brian Robert Chisdak | Oral & Maxillofacial Surgery | 1994 Stadium Dr., Bozeman, MT 59715 | 2007-05-03 |
| 1962003616 | Kalispell Oral Surgery Center LLC | Oral & Maxillofacial Surgery | 180 Timberwolf Pkwy, Kalispell, MT 59901-1218 | 2020-11-07 |
| 1407301872 | Kalispell Regional Medical Center Inc | Oral & Maxillofacial Surgery | 711 E 13th St, Suite 101, Whitefish, MT 59937-2964 | 2016-08-16 |
| 1326499310 | David M Weber Dds Md PC | Oral & Maxillofacial Surgery | 180 Timberwolf Pkwy, Kalispell, MT 59901-1218 | 2016-06-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.