Individual
DR. TAYLOR AUSTIN ELLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
21300 HIGHWAY 62, SHADY COVE, OR 97539-7707
(541) 878-2115
(541) 878-2117
Mailing address
PO BOX 1150, SHADY COVE, OR 97539-1150
(541) 878-2115
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11324
OR
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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