Provider Demographics
NPI:1730329046
Name:TAYLOR, GERD SOLVEIG (BS, RDH)
Entity type:Individual
Prefix:MRS
First Name:GERD
Middle Name:SOLVEIG
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:BS, RDH
Other - Prefix:
Other - First Name:GERD
Other - Middle Name:SOLVEIG
Other - Last Name:(ROGNAAS) TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5550 UPPER RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526
Mailing Address - Country:US
Mailing Address - Phone:541-479-6189
Mailing Address - Fax:541-479-6189
Practice Address - Street 1:5550 UPPER RIVER ROAD
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526
Practice Address - Country:US
Practice Address - Phone:541-479-6189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH0354124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist