Healthcare Provider Details

I. General information

NPI: 1700686813
Provider Name (Legal Business Name): TAYLOR LYNN RAGER RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5010 BUCKEYSTOWN PIKE
FREDERICK MD
21704-8339
US

IV. Provider business mailing address

88 FINNEY DR
MARTINSBURG WV
25405-1118
US

V. Phone/Fax

Practice location:
  • Phone: 301-620-8869
  • Fax: 301-620-8894
Mailing address:
  • Phone: 304-283-4842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number8433
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: