Provider Demographics
NPI:1730116369
Name:TAYLOR, CATHY MARLENE (DMD)
Entity type:Individual
Prefix:DR
First Name:CATHY
Middle Name:MARLENE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 NW 36TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-6019
Mailing Address - Country:US
Mailing Address - Phone:352-335-6689
Mailing Address - Fax:
Practice Address - Street 1:4040 W NEWBERRY RD
Practice Address - Street 2:SUITE 1200
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-5503
Practice Address - Country:US
Practice Address - Phone:352-376-3400
Practice Address - Fax:352-376-3400
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN171071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice