Individual
DR. JEREMY TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8430 MARKET ST, BOARDMAN, OH 44512-6701
(330) 758-0505
Mailing address
80 SLEEPY HOLLOW DR, CANFIELD, OH 44406-1055
(440) 371-2422
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30.025461
OH
1223G0001X
General Practice Dentistry
Primary
30.025461
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0229522
—
OH
Enumeration date
05/30/2017
Last updated
05/05/2021
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