Provider Demographics
NPI:1275607483
Name:SEELHAMMER TAYLOR, RENEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:
Last Name:SEELHAMMER TAYLOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7674 DESIGN RD
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56425-8439
Mailing Address - Country:US
Mailing Address - Phone:218-828-4816
Mailing Address - Fax:218-828-2095
Practice Address - Street 1:7674 DESIGN RD
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-8439
Practice Address - Country:US
Practice Address - Phone:218-828-4816
Practice Address - Fax:218-828-2095
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice