Healthcare Provider Details

I. General information

NPI: 1336174846
Provider Name (Legal Business Name): CATON & TAYLOR PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 NW 40TH TERRACE STE C
GAINESVILLE FL
32605
US

IV. Provider business mailing address

2121 NW 40TH TERRACE STE C
GAINESVILLE FL
32605
US

V. Phone/Fax

Practice location:
  • Phone: 352-378-2525
  • Fax: 352-377-9772
Mailing address:
  • Phone: 352-378-2525
  • Fax: 352-377-9772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN4270
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDM13187
License Number StateFL

VIII. Authorized Official

Name: DR. GLENN N TAYLOR JR.
Title or Position: ORAL SURGEON
Credential: DMD MD
Phone: 352-378-2525