Provider Demographics
NPI:1447499207
Name:SORIANO-TAYLOR, IMELDA G (DDS)
Entity type:Individual
Prefix:DR
First Name:IMELDA
Middle Name:G
Last Name:SORIANO-TAYLOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MEL
Other - Middle Name:
Other - Last Name:SORIANO-TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2150 BLACK ROCK TPKE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3239
Mailing Address - Country:US
Mailing Address - Phone:203-333-2060
Mailing Address - Fax:203-333-0027
Practice Address - Street 1:2150 BLACK ROCK TPKE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3239
Practice Address - Country:US
Practice Address - Phone:203-333-2060
Practice Address - Fax:203-333-0027
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT08167122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist