Provider Demographics
NPI:1962542191
Name:TAYLOR, GREGORY DEAN (DDS)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:DEAN
Last Name:TAYLOR
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 1:889 EMBARCADERO DRIVE
Mailing Address - Street 2:#201
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762
Mailing Address - Country:US
Mailing Address - Phone:916-933-6282
Mailing Address - Fax:916-933-4834
Practice Address - Street 1:889 EMBARCADERO DRIVE
Practice Address - Street 2:#201
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762
Practice Address - Country:US
Practice Address - Phone:916-933-6282
Practice Address - Fax:916-933-4834
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35348122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist