Provider Demographics
NPI:1326050915
Name:TAYLOR, GARY EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:EDWARD
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5223 REGATTA POINTE ROAD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3521
Mailing Address - Country:US
Mailing Address - Phone:757-477-0536
Mailing Address - Fax:757-399-6779
Practice Address - Street 1:416 E COLONIAL AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909
Practice Address - Country:US
Practice Address - Phone:252-338-0143
Practice Address - Fax:252-338-8194
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC44081223X0400X
VA51161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics