Provider Demographics
NPI:1447382429
Name:TAFF, J. ANDREW (DDS)
Entity type:Individual
Prefix:DR
First Name:J.
Middle Name:ANDREW
Last Name:TAFF
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 1:303 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-1312
Mailing Address - Country:US
Mailing Address - Phone:765-932-2738
Mailing Address - Fax:765-932-3113
Practice Address - Street 1:303 E 11TH ST
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173-1312
Practice Address - Country:US
Practice Address - Phone:765-932-2738
Practice Address - Fax:765-932-3113
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120086601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice